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General NPI Number Information
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NPI Number | 1184931875
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Entity Type | Organization
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Legal Business Name | PROMOTING PARTICIPATION
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Dates
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Enumeration Date | 09/02/2010
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Last Update Date | 09/02/2010
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Provider Practice Location Address
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Address Line | 24 NEW HAMPSHIRE DR UNIT C9
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City | NEW BRITAIN
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State | CT
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Zip | 06052-1170
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Country | US
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Telephone | 860-798-8638
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Fax |
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Provider Business Mailing Address
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Address Line | 24 NEW HAMPSHIRE DR UNIT C9
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City | NEW BRITAIN
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State | CT
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Zip | 06052-1170
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Country | US
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Telephone | 860-798-8638
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Fax |
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPIST
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Name | MS. MELISSA R OLSON
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Credential | M.S. SPED/AT, OTR/L
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Telephone | 860-798-8638
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 002262
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License Number State | CT
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