Healthcare Provider Details

I. General information

NPI: 1063025534
Provider Name (Legal Business Name): CASEY HUTCHINSON OCCUPATIONAL THERAPI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2020
Last Update Date: 08/25/2020
Certification Date: 08/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

308 RACEBROOK ROAD
ORANGE CT
06477
US

IV. Provider business mailing address

382 S MAIN ST
CHESHIRE CT
06410-1379
US

V. Phone/Fax

Practice location:
  • Phone: 203-920-1885
  • Fax: 203-920-1881
Mailing address:
  • Phone: 203-250-9663
  • Fax: 203-699-9641

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number5446
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: