Theresa Maureen Grey, COTA/L

Key facts

NPI

1013580315

Entity type

Individual (NPI type 1)

Primary specialty

Occupational Therapy Assistant 224Z00000X

License

001594 (CT)

Practice address

1089A Woodtick Rd
Wolcott, CT 06716-2123

Phone

(860) 874-8443

NPI assigned

Jul 23, 2021

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 23, 2021.

{
    "created_epoch": "1626998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626998400000",
    "number": "1013580315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1089A WOODTICK RD",
            "city": "WOLCOTT",
            "state": "CT",
            "postal_code": "067162123",
            "telephone_number": "860-874-8443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1089A WOODTICK RD",
            "city": "WOLCOTT",
            "state": "CT",
            "postal_code": "067162123",
            "telephone_number": "860-874-8443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREY",
        "first_name": "THERESA",
        "middle_name": "MAUREEN",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-23",
        "last_updated": "2021-07-23",
        "certification_date": "2021-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CT",
            "license": "001594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Amy Lisa Guyette, LPC
• Gayle Gwozdz, A.P.R.N.
• Amber S Hayes, PT
• Jaylin Holland, ND
• Charles Housemann

All providers in Wolcott, CT · Occupational Therapy Assistant in Connecticut