Healthcare Provider Details

I. General information

NPI: 1053437210
Provider Name (Legal Business Name): KAREN PATTEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

61 GREENWAY
VERNON VT
05354-9474
US

IV. Provider business mailing address

35 WALNUT ST
GREENFIELD MA
01301-2507
US

V. Phone/Fax

Practice location:
  • Phone: 802-254-6041
  • Fax: 802-257-5362
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number0730000178
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: