Basic Information
| Provider Information | |||||||||
| NPI: | 1366483281 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DUSSAULT | ||||||||
| FirstName: | LAURA | ||||||||
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| Credential: | OTR/CHT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 105 NEWTOWN RD # A | ||||||||
| Address2: | |||||||||
| City: | DANBURY | ||||||||
| State: | CT | ||||||||
| PostalCode: | 068104194 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2037390765 | ||||||||
| FaxNumber: | 2037390792 | ||||||||
| Practice Location | |||||||||
| Address1: | 35 TAMARACK AVE | ||||||||
| Address2: | |||||||||
| City: | DANBURY | ||||||||
| State: | CT | ||||||||
| PostalCode: | 068114959 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2037301026 | ||||||||
| FaxNumber: | 2037301027 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/10/2006 | ||||||||
| LastUpdateDate: | 09/29/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225XH1200X | 000144 | CT | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Hand |
No ID Information.