Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 5662 | CT |
N | 225XM0800X | Mental Health | 5662 | CT |
N | 225XP0200X | Occupational Therapist - Pediatrics | 5662 | CT |
NPI | 1033787627 |
---|---|
Provider Name | Allison Nicole Dube |
First Address | Avon, CT 06001-3935 |
Second Address | Torrington, CT 06790-7224 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2021 |
Last Update Date | 11/06/2021 |