Provider Demographics
NPI:1487828463
Name:GILSON, VALERIE PEYTON (COTA/L)
Entity Type:Individual
Prefix:MS
First Name:VALERIE
Middle Name:PEYTON
Last Name:GILSON
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 1:4 GREENTREE DR
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06385-4116
Mailing Address - Country:US
Mailing Address - Phone:860-442-0647
Mailing Address - Fax:860-437-0123
Practice Address - Street 1:4 GREENTREE DR
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:CT
Practice Address - Zip Code:06385-4116
Practice Address - Country:US
Practice Address - Phone:860-442-0647
Practice Address - Fax:860-437-0123
Is Sole Proprietor?:No
Enumeration Date:2008-04-21
Last Update Date:2008-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000502224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant