Provider Demographics
NPI:1205505153
Name:KOKKINOS, EMMA LOUISE (MS, OTR/L)
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:LOUISE
Last Name:KOKKINOS
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 1:129 WALLACE RD
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-5161
Mailing Address - Country:US
Mailing Address - Phone:603-498-9997
Mailing Address - Fax:
Practice Address - Street 1:40 SEWALLS FALLS RD
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-4649
Practice Address - Country:US
Practice Address - Phone:603-225-0853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-13
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3076225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist