Provider Demographics
NPI:1356476550
Name:CHOQUETTE, REBECCA HELEN (ATC)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:HELEN
Last Name:CHOQUETTE
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 KENDRA DR.
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:VT
Mailing Address - Zip Code:05468
Mailing Address - Country:US
Mailing Address - Phone:802-656-9575
Mailing Address - Fax:802-656-9578
Practice Address - Street 1:140 PATRICK GYMNASIUM
Practice Address - Street 2:UNIVERSITY OF VERMONT
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05468
Practice Address - Country:US
Practice Address - Phone:802-656-9575
Practice Address - Fax:802-656-9578
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT104-0000038174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist