Provider Demographics
NPI:1720452139
Name:PATTERSON, TODD ERIC (OTR/L)
Entity Type:Individual
Prefix:MR
First Name:TODD
Middle Name:ERIC
Last Name:PATTERSON
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 HOWARD DR
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:VT
Mailing Address - Zip Code:05468-3504
Mailing Address - Country:US
Mailing Address - Phone:917-517-5852
Mailing Address - Fax:
Practice Address - Street 1:300 PEARL ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-8531
Practice Address - Country:US
Practice Address - Phone:802-658-4200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-23
Last Update Date:2015-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT072.0000489225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist