Provider Demographics
NPI:1588011647
Name:NELSON, CAITLIN (OTR/L)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:
Last Name:NELSON
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 1:25 BOURASSA RD
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NH
Mailing Address - Zip Code:03251-4203
Mailing Address - Country:US
Mailing Address - Phone:603-991-9335
Mailing Address - Fax:
Practice Address - Street 1:25 BOURASSA RD
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NH
Practice Address - Zip Code:03251-4203
Practice Address - Country:US
Practice Address - Phone:603-991-9335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-18
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2553225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist