Provider Demographics
NPI:1154529451
Name:DUPONT, ELIZABETH MARIA FELCYN (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:MARIA FELCYN
Last Name:DUPONT
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MISS
Other - First Name:ELIZABETH
Other - Middle Name:MARIA
Other - Last Name:FELCYN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:596 SHELDON ROAD
Mailing Address - Street 2:
Mailing Address - City:ST. ALBANS
Mailing Address - State:VT
Mailing Address - Zip Code:05478
Mailing Address - Country:US
Mailing Address - Phone:802-524-6534
Mailing Address - Fax:802-524-2429
Practice Address - Street 1:596 SHELDON ROAD
Practice Address - Street 2:
Practice Address - City:ST ALBANS
Practice Address - State:VT
Practice Address - Zip Code:05478
Practice Address - Country:US
Practice Address - Phone:802-524-6534
Practice Address - Fax:802-524-2429
Is Sole Proprietor?:No
Enumeration Date:2007-07-07
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT072-0000474225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist