Sandra Lee Dizenzo, COTA/L

Individual provider Active NPI Occupational Therapy Assistant · North Branford, CT

NPI 1922582253 · NPPES record last updated Sep 22, 2018

Key facts

NPI
1922582253
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
001041 (CT)
Practice address
88 Notch Hill Rd
North Branford, CT 06471-1846
Phone
(203) 488-8000
NPI assigned
Sep 22, 2018
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

State licenses

LicenseStateTypeSpecialty
001041CTMDClinical Psychologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 001041 CT Yes

Addresses

Primary practice location

88 Notch Hill Rd
North Branford, CT 06471-1846

Mailing address

5 S Cove Rd
Old Saybrook, CT 06475-2585
Phone (860) 391-8444

Other providers in North Branford, CT

All providers in North Branford, CT · Occupational Therapy Assistant in Connecticut

Sources for this page

Verify at the official NPI Registry.