Provider Demographics
NPI:1225672322
Name:TWIN STATE OCCUPATIONAL THERAPY PLC
Entity Type:Organization
Organization Name:TWIN STATE OCCUPATIONAL THERAPY PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:M
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:802-674-4655
Mailing Address - Street 1:PO BOX 388
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:VT
Mailing Address - Zip Code:05089-0388
Mailing Address - Country:US
Mailing Address - Phone:802-674-4655
Mailing Address - Fax:802-674-4656
Practice Address - Street 1:54 MAIN ST # LL2
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:VT
Practice Address - Zip Code:05089-1321
Practice Address - Country:US
Practice Address - Phone:802-674-4655
Practice Address - Fax:802-674-4656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-31
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Single Specialty