Provider Demographics
NPI:1215391685
Name:PAQUETTE, TODD M (COTA/L)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:M
Last Name:PAQUETTE
Suffix:
Gender:M
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 DARTMOUTH ST
Mailing Address - Street 2:
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-4528
Mailing Address - Country:US
Mailing Address - Phone:802-224-6156
Mailing Address - Fax:
Practice Address - Street 1:16 DARTMOUTH ST
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-4528
Practice Address - Country:US
Practice Address - Phone:802-224-6156
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-11
Last Update Date:2016-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3597225XG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontology