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General NPI Number Information
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NPI Number | 1215391685
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Entity Type | Individual
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Provider Name | TODD M PAQUETTE COTA/L
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Gender | Male
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Dates
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Enumeration Date | 04/11/2016
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Last Update Date | 04/11/2016
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Provider Practice Location Address
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Address Line | 16 DARTMOUTH ST
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City | HYANNIS
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State | MA
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Zip | 02601-4528
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Country | US
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Telephone | 802-224-6156
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Fax |
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Provider Business Mailing Address
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Address Line | 16 DARTMOUTH ST
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City | HYANNIS
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State | MA
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Zip | 02601-4528
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Country | US
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Telephone | 802-224-6156
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XG0600X
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Taxonomy Name | Gerontology Occupational Therapist
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License Number | 3597
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License Number State | MA
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