Provider Demographics
NPI:1285840991
Name:DELANEY, MARY ANN
Entity Type:Individual
Prefix:MS
First Name:MARY ANN
Middle Name:
Last Name:DELANEY
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:MARYANN
Other - Middle Name:
Other - Last Name:DELANEY TUTTLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:195 OLD POST RD
Mailing Address - Street 2:
Mailing Address - City:TOLLAND
Mailing Address - State:CT
Mailing Address - Zip Code:06084-3307
Mailing Address - Country:US
Mailing Address - Phone:860-870-7701
Mailing Address - Fax:
Practice Address - Street 1:195 OLD POST RD
Practice Address - Street 2:
Practice Address - City:TOLLAND
Practice Address - State:CT
Practice Address - Zip Code:06084-3307
Practice Address - Country:US
Practice Address - Phone:860-870-7701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0038492251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics