Provider Demographics
NPI:1710172671
Name:KOGUT, LINDA M (MA OTR)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:M
Last Name:KOGUT
Suffix:
Gender:F
Credentials:MA OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 STONEFENCE RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VT
Mailing Address - Zip Code:05477-2202
Mailing Address - Country:US
Mailing Address - Phone:802-434-4036
Mailing Address - Fax:802-434-4036
Practice Address - Street 1:29 STONEFENCE RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VT
Practice Address - Zip Code:05477-2202
Practice Address - Country:US
Practice Address - Phone:802-434-4036
Practice Address - Fax:802-434-4036
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-12
Last Update Date:2011-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT072.0000063225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1750421772OtherNPI