Provider Demographics
NPI:1063539906
Name:BURNS, CAROLINE W (OTRL)
Entity type:Individual
Prefix:MRS
First Name:CAROLINE
Middle Name:W
Last Name:BURNS
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:CAROLINE
Other - Middle Name:W
Other - Last Name:FORBES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTRL
Mailing Address - Street 1:86 PINE ST
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01085-1042
Mailing Address - Country:US
Mailing Address - Phone:413-562-0283
Mailing Address - Fax:
Practice Address - Street 1:490 BLUE HILLS AVE
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06112-1513
Practice Address - Country:US
Practice Address - Phone:860-714-3500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003044225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist