Provider Demographics
NPI:1841657095
Name:BUTT, DENISE MARIE (OTR/L)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:MARIE
Last Name:BUTT
Suffix:
Gender:F
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 1:489 CARRIAGE DR
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CT
Mailing Address - Zip Code:06477-2917
Mailing Address - Country:US
Mailing Address - Phone:203-671-1667
Mailing Address - Fax:
Practice Address - Street 1:489 CARRIAGE DR
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CT
Practice Address - Zip Code:06477-2917
Practice Address - Country:US
Practice Address - Phone:203-671-1667
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-19
Last Update Date:2016-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002443225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist