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General NPI Number Information
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NPI Number | 1750418364
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Entity Type | Organization
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Legal Business Name | THERAPEIA LYMPHEDEMA CENTER, LLC
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 02/12/2014
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Provider Practice Location Address
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Address Line | 3074 WHITNEY AVE BUILDING 1
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City | HAMDEN
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State | CT
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Zip | 06518-2391
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Country | US
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Telephone | 203-230-2800
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Fax | 203-230-9791
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Provider Business Mailing Address
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Address Line | 3074 WHITNEY AVE BUILDING 1
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City | HAMDEN
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State | CT
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Zip | 06518-2391
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Country | US
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Telephone | 203-230-2800
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Fax | 203-230-9791
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Authorized Official
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Title or Position | OWNER
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Name | LINDA M HODGKINS
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Credential | OTR
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Telephone | 203-230-2800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 001887
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License Number State | CT
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