MEDICARE: DR. SONIA PAQUETTE OTD, OTR/L, CPE, ABV

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	OC009924	PA
2	225X00000X	Occupational Therapist	U1-0001040	DE
3	225X00000X	Occupational Therapist	03372	MD
4	225XE1200X	Ergonomics Occupational Therapist	03372	MD
5	225XE1200X	Ergonomics Occupational Therapist	OC009924	PA
6	225XE1200X	Ergonomics Occupational Therapist	U1-0001040	DE

General Provider Information

NPI Number	:	1033358452
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SONIA PAQUETTE OTD, OTR/L, CPE, ABV

Provider Business Mailing Address
First Line	:	17505 HIDDEN GARDEN LN
Second Line	:
City	:	ASHTON
State	:	MD
Zip	:	20861-3652
Country	:	US
Telephone Number	:	484-364-1619
Fax Number	:	866-861-8659

Provider Business Practice Location Address
First Line	:	17505 HIDDEN GARDEN LN
Second Line	:
City	:	ASHTON
State	:	MD
Zip	:	20861-3652
Country	:	US
Telephone Number	:	484-364-1619
Fax Number	:	866-861-8659

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/09/2009
Last Update Date	:	01/09/2017

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