Provider Demographics
NPI:1437599750
Name:HUNTER, CONSTANCE MACLEOD (OTR/L)
Entity Type:Individual
Prefix:
First Name:CONSTANCE
Middle Name:MACLEOD
Last Name:HUNTER
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:PO BOX 854
Mailing Address - Street 2:
Mailing Address - City:OLD LYME
Mailing Address - State:CT
Mailing Address - Zip Code:06371-0854
Mailing Address - Country:US
Mailing Address - Phone:860-434-5524
Mailing Address - Fax:860-434-3262
Practice Address - Street 1:19 HALLS RD
Practice Address - Street 2:SUITE 204
Practice Address - City:OLD LYME
Practice Address - State:CT
Practice Address - Zip Code:06371-1457
Practice Address - Country:US
Practice Address - Phone:860-434-5524
Practice Address - Fax:860-434-3262
Is Sole Proprietor?:No
Enumeration Date:2013-07-01
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000244225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist