Provider Demographics
NPI:1942991831
Name:HILLMON, THOMASINA E (MS, COTA/L)
Entity Type:Individual
Prefix:
First Name:THOMASINA
Middle Name:E
Last Name:HILLMON
Suffix:
Gender:F
Credentials:MS, COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 380336
Mailing Address - Street 2:
Mailing Address - City:EAST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06138-0336
Mailing Address - Country:US
Mailing Address - Phone:860-680-7595
Mailing Address - Fax:
Practice Address - Street 1:ST. JOSEPH'S RESIDENCE
Practice Address - Street 2:1365 ENFIELD STREET
Practice Address - City:ENFIELD
Practice Address - State:CT
Practice Address - Zip Code:06082
Practice Address - Country:US
Practice Address - Phone:860-741-0791
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-19
Last Update Date:2023-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1174224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant