Healthcare Provider Details

I. General information

NPI: 1922510098
Provider Name (Legal Business Name): CAITLIN MARSHALL OTR/:
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2017
Last Update Date: 06/07/2022
Certification Date: 06/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 COLCHESTER AVE # 2
BURLINGTON VT
05401-1473
US

IV. Provider business mailing address

34 CORDUROY RD
ESSEX JUNCTION VT
05452-4732
US

V. Phone/Fax

Practice location:
  • Phone: 802-847-2450
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number072.0133892
License Number StateVT
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: