Deborah Bergendahl, COTA

Individual provider Active NPI Occupational Therapy Assistant · Rocky Hill, CT

NPI 1285843722 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1285843722
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
000974 (CT)
Practice address
60 West St
Rocky Hill, CT 06067-3518
Phone
(860) 529-2521
Fax
(860) 563-2640
NPI assigned
May 22, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 000974 CT Yes

Addresses

Primary practice location

60 West St
Rocky Hill, CT 06067-3518

Mailing address

68 Concord St
East Hartford, CT 06108-2942
Phone (860) 289-2356

Other providers in Rocky Hill, CT

All providers in Rocky Hill, CT · Occupational Therapy Assistant in Connecticut

Sources for this page

Verify at the official NPI Registry.