Provider Demographics
NPI:1114041977
Name:PERRY, CONSTANCE C (MS OTRL)
Entity Type:Individual
Prefix:
First Name:CONSTANCE
Middle Name:C
Last Name:PERRY
Suffix:
Gender:F
Credentials:MS OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 THORNTON FERRY ROAD I
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NH
Mailing Address - Zip Code:03031-2601
Mailing Address - Country:US
Mailing Address - Phone:603-673-3345
Mailing Address - Fax:603-673-4944
Practice Address - Street 1:40 THORNTON FERRY ROAD I
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NH
Practice Address - Zip Code:03031-2601
Practice Address - Country:US
Practice Address - Phone:603-673-3345
Practice Address - Fax:603-673-4944
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0785225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics