Provider Demographics
NPI:1477034098
Name:OCONNELL, DOREEN FRANCES (COTA)
Entity Type:Individual
Prefix:
First Name:DOREEN
Middle Name:FRANCES
Last Name:OCONNELL
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 RHODES RD
Mailing Address - Street 2:
Mailing Address - City:TOLLAND
Mailing Address - State:CT
Mailing Address - Zip Code:06084-3506
Mailing Address - Country:US
Mailing Address - Phone:860-989-0879
Mailing Address - Fax:
Practice Address - Street 1:112 RHODES RD
Practice Address - Street 2:
Practice Address - City:TOLLAND
Practice Address - State:CT
Practice Address - Zip Code:06084-3506
Practice Address - Country:US
Practice Address - Phone:860-989-0879
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-22
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ046631224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant