Provider Demographics
NPI:1477891158
Name:THURSTON, ALLISON (OTR/L)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:THURSTON
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 1:296 BURNHAM RD
Mailing Address - Street 2:
Mailing Address - City:EAST THETFORD
Mailing Address - State:VT
Mailing Address - Zip Code:05043-9662
Mailing Address - Country:US
Mailing Address - Phone:802-299-6378
Mailing Address - Fax:
Practice Address - Street 1:296 BURNHAM RD
Practice Address - Street 2:
Practice Address - City:EAST THETFORD
Practice Address - State:VT
Practice Address - Zip Code:05043-9662
Practice Address - Country:US
Practice Address - Phone:802-299-6378
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-30
Last Update Date:2013-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10520225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist