Provider Demographics
NPI:1922384908
Name:DAIGLE, KAREN M (MS, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:M
Last Name:DAIGLE
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 SURREY PL
Mailing Address - Street 2:
Mailing Address - City:WETHERSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06109-4065
Mailing Address - Country:US
Mailing Address - Phone:860-257-8380
Mailing Address - Fax:
Practice Address - Street 1:17 FARMINGTON AVE
Practice Address - Street 2:
Practice Address - City:PLAINVILLE
Practice Address - State:CT
Practice Address - Zip Code:06062-1700
Practice Address - Country:US
Practice Address - Phone:860-351-5407
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-23
Last Update Date:2011-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT03-261568225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist