Provider Demographics
NPI:1801972112
Name:DUFFY, JANE (OTR)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:
Last Name:DUFFY
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 1:355 RIVER ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VT
Mailing Address - Zip Code:05156-2221
Mailing Address - Country:US
Mailing Address - Phone:802-886-1954
Mailing Address - Fax:
Practice Address - Street 1:1862 VT ROUTE 106
Practice Address - Street 2:
Practice Address - City:PERKINSVILLE
Practice Address - State:VT
Practice Address - Zip Code:05151-9613
Practice Address - Country:US
Practice Address - Phone:802-263-9224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1402225X00000X
VT072-0000320225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Not Answered225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics