Provider Demographics
NPI:1770157422
Name:ARABY, JACLYN H (OT)
Entity type:Individual
Prefix:
First Name:JACLYN
Middle Name:H
Last Name:ARABY
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:JACLYN
Other - Middle Name:H
Other - Last Name:CMERO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:297 HOUSE ST
Mailing Address - Street 2:
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-1264
Mailing Address - Country:US
Mailing Address - Phone:413-427-9783
Mailing Address - Fax:
Practice Address - Street 1:52 MISSIONARY RD
Practice Address - Street 2:
Practice Address - City:CROMWELL
Practice Address - State:CT
Practice Address - Zip Code:06416-2170
Practice Address - Country:US
Practice Address - Phone:860-316-4677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-18
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT3416225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist