Provider Demographics
NPI:1619037470
Name:PERREAULT, DEANNA B (PT)
Entity Type:Individual
Prefix:MRS
First Name:DEANNA
Middle Name:B
Last Name:PERREAULT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:DEANNA
Other - Middle Name:J
Other - Last Name:BERNIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:PO BOX 32
Mailing Address - Street 2:18 PEPPER ROAD
Mailing Address - City:CHELSEA
Mailing Address - State:VT
Mailing Address - Zip Code:05038-0032
Mailing Address - Country:US
Mailing Address - Phone:802-685-4553
Mailing Address - Fax:
Practice Address - Street 1:INTERSECTION RTS 4 AND 12
Practice Address - Street 2:
Practice Address - City:TAFTSVILLE
Practice Address - State:VT
Practice Address - Zip Code:05073
Practice Address - Country:US
Practice Address - Phone:802-457-4487
Practice Address - Fax:802-457-9428
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT040-00033472251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics