Kristin Anne Antonucci, OTR
Individual provider Active NPI Occupational Therapist · Middlebury, CT
NPI 1700919149 · NPPES record last updated Nov 10, 2010
Key facts
- NPI
- 1700919149
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- Practice address
- 590 Middlebury Rd
Middlebury, CT 06762-2562 - Phone
- (203) 577-3700
- NPI assigned
- Mar 14, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 003337 | CT | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advance Therapy Associates LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | Yes |
Addresses
Primary practice location
590 Middlebury Rd
Middlebury, CT 06762-2562
Mailing address
110 Woodbury Rd
Watertown, CT 06795-2130
Phone (917) 532-4883
Other names
- Kristin Anne Wetterhahn
Other providers in Middlebury, CT
- Anchor Clinical Solutions, LLC
- Janet Lynn Anderson-Ray
- Michelle L Andrews
- Joseph P Antoci
- George V Antonopoulos
- Matthew T Ariyavatkul
- Matthew Arnone
- Amy K Arruda
- Karen Arzuaga
- Augustine Counseling, LLC
All providers in Middlebury, CT · Occupational Therapist in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 10, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.