Provider Demographics
NPI:1164143970
Name:PARENT, MCAUL (OT)
Entity Type:Individual
Prefix:
First Name:MCAUL
Middle Name:
Last Name:PARENT
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 HAYWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:RUTLAND
Mailing Address - State:VT
Mailing Address - Zip Code:05701-4832
Mailing Address - Country:US
Mailing Address - Phone:802-775-0007
Mailing Address - Fax:
Practice Address - Street 1:3044 WALKER MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:WEST RUTLAND
Practice Address - State:VT
Practice Address - Zip Code:05777-9261
Practice Address - Country:US
Practice Address - Phone:978-877-7670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-09
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT072.0098495225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist