Provider Demographics
NPI:1346879582
Name:DOPFEL, DEVON ANNE (LMT)
Entity Type:Individual
Prefix:
First Name:DEVON
Middle Name:ANNE
Last Name:DOPFEL
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 STONE PASTURE LN
Mailing Address - Street 2:
Mailing Address - City:KILLINGWORTH
Mailing Address - State:CT
Mailing Address - Zip Code:06419-1369
Mailing Address - Country:US
Mailing Address - Phone:508-904-3540
Mailing Address - Fax:
Practice Address - Street 1:170 BOSTON POST RD UNIT 3
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:CT
Practice Address - Zip Code:06443-2166
Practice Address - Country:US
Practice Address - Phone:860-245-1249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-08
Last Update Date:2020-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT008183225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty