Provider Demographics
NPI:1629687116
Name:PIDGEON, SHERRY JEANNE (OTR/L)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:JEANNE
Last Name:PIDGEON
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 1:376 PUMPKIN HL
Mailing Address - Street 2:
Mailing Address - City:WILLISTON
Mailing Address - State:VT
Mailing Address - Zip Code:05495-9008
Mailing Address - Country:US
Mailing Address - Phone:802-578-3440
Mailing Address - Fax:
Practice Address - Street 1:376 PUMPKIN HL
Practice Address - Street 2:
Practice Address - City:WILLISTON
Practice Address - State:VT
Practice Address - Zip Code:05495-9008
Practice Address - Country:US
Practice Address - Phone:802-578-3440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-30
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT072.0000-248225XE0001X
VT072.0000248225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XE0001XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistEnvironmental ModificationGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty