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General NPI Number Information
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NPI Number | 1730788431
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Entity Type | Individual
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Provider Name | MICHELLE CANO OTA/L
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Gender | Female
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Dates
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Enumeration Date | 10/22/2020
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Last Update Date | 10/22/2020
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Provider Practice Location Address
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Address Line | 65 COMMERCIAL BLVD
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City | TORRINGTON
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State | CT
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Zip | 06790-3097
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Country | US
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Telephone | 860-996-1696
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Fax |
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Provider Business Mailing Address
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Address Line | 43 NASER RD
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City | LITCHFIELD
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State | CT
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Zip | 06759-3020
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Country | US
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Telephone | 860-302-0442
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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 | 000790
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License Number State | CT
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