Provider Demographics
NPI:1831252873
Name:AHRENS, DENISE (OT)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:AHRENS
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 BRANFORD RD
Mailing Address - Street 2:UNIT 412
Mailing Address - City:NORTH BRANFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06471-1360
Mailing Address - Country:US
Mailing Address - Phone:203-848-4591
Mailing Address - Fax:
Practice Address - Street 1:636 CAMPBELL AVE
Practice Address - Street 2:
Practice Address - City:WEST HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06516-4408
Practice Address - Country:US
Practice Address - Phone:203-934-6690
Practice Address - Fax:203-934-6659
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000672225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT000672OtherOT LICENSE