Provider Demographics
NPI:1275140717
Name:THOMPSON, CAITLIN M (OTR/L)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:M
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7731 STATE ROUTE 22
Mailing Address - Street 2:
Mailing Address - City:WEST CHAZY
Mailing Address - State:NY
Mailing Address - Zip Code:12992-3230
Mailing Address - Country:US
Mailing Address - Phone:518-534-5230
Mailing Address - Fax:
Practice Address - Street 1:128 PARK ROW STE 101
Practice Address - Street 2:
Practice Address - City:CADYVILLE
Practice Address - State:NY
Practice Address - Zip Code:12918-2817
Practice Address - Country:US
Practice Address - Phone:518-561-6361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-29
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant