Healthcare Provider Details

I. General information

NPI: 1033358452
Provider Name (Legal Business Name): SONIA PAQUETTE OTD, OTR/L, CPE, ABV
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/09/2009
Last Update Date: 01/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17505 HIDDEN GARDEN LN
ASHTON MD
20861-3652
US

IV. Provider business mailing address

17505 HIDDEN GARDEN LN
ASHTON MD
20861-3652
US

V. Phone/Fax

Practice location:
  • Phone: 484-364-1619
  • Fax: 866-861-8659
Mailing address:
  • Phone: 484-364-1619
  • Fax: 866-861-8659

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOC009924
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberU1-0001040
License Number StateDE
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number03372
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code225XE1200X
TaxonomyErgonomics Occupational Therapist
License Number03372
License Number StateMD
# 5
Primary TaxonomyN
Taxonomy Code225XE1200X
TaxonomyErgonomics Occupational Therapist
License NumberOC009924
License Number StatePA
# 6
Primary TaxonomyN
Taxonomy Code225XE1200X
TaxonomyErgonomics Occupational Therapist
License NumberU1-0001040
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: