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General NPI Number Information
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NPI Number | 1285882290
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Entity Type | Individual
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Provider Name | JOY MARIE CONSIGLIO COTA/L, LMT
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Gender | Female
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Dates
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Enumeration Date | 09/03/2008
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Last Update Date | 03/21/2016
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Provider Practice Location Address
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Address Line | 32 COACH DR
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City | NORTH HAVEN
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State | CT
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Zip | 06473-1511
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Country | US
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Telephone | 860-748-7515
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Fax |
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Provider Business Mailing Address
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Address Line | 32 COACH DR
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City | NORTH HAVEN
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State | CT
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Zip | 06473-1511
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Country | US
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Telephone | 860-748-7515
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 000989
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 00735
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License Number State | CT
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