Provider Demographics
NPI:1457561334
Name:JONES, CAROLYN BOTTI (OTR)
Entity Type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:BOTTI
Last Name:JONES
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:265 VALLEY VIEW DR
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06040-6940
Mailing Address - Country:US
Mailing Address - Phone:860-432-2397
Mailing Address - Fax:
Practice Address - Street 1:180 REGAN RD
Practice Address - Street 2:
Practice Address - City:VERNON
Practice Address - State:CT
Practice Address - Zip Code:06066-2824
Practice Address - Country:US
Practice Address - Phone:860-871-0385
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002667225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist