Provider Demographics
NPI:1346002078
Name:LAGGIS, JILLIAN (OTRL)
Entity Type:Individual
Prefix:
First Name:JILLIAN
Middle Name:
Last Name:LAGGIS
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:197 VILLAGE POND RD
Mailing Address - Street 2:
Mailing Address - City:GUILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06437-2049
Mailing Address - Country:US
Mailing Address - Phone:203-859-1264
Mailing Address - Fax:
Practice Address - Street 1:197 VILLAGE POND RD
Practice Address - Street 2:
Practice Address - City:GUILFORD
Practice Address - State:CT
Practice Address - Zip Code:06437-2049
Practice Address - Country:US
Practice Address - Phone:203-859-1264
Practice Address - Fax:475-900-3040
Is Sole Proprietor?:No
Enumeration Date:2024-01-29
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT6361225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist