Provider Demographics
NPI:1437899671
Name:KINGSBURY, EMILY (COTA/L)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:KINGSBURY
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 ROSE HAVEN RD
Mailing Address - Street 2:
Mailing Address - City:SOMERS
Mailing Address - State:CT
Mailing Address - Zip Code:06071-1216
Mailing Address - Country:US
Mailing Address - Phone:860-681-3498
Mailing Address - Fax:
Practice Address - Street 1:25 ROSE HAVEN RD
Practice Address - Street 2:
Practice Address - City:SOMERS
Practice Address - State:CT
Practice Address - Zip Code:06071-1216
Practice Address - Country:US
Practice Address - Phone:860-681-3498
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-29
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant