Provider Demographics
NPI:1427423557
Name:BURT, FLORENCE A (OTR/L)
Entity type:Individual
Prefix:
First Name:FLORENCE
Middle Name:A
Last Name:BURT
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 1:1435 CHESTER RD
Mailing Address - Street 2:
Mailing Address - City:GRAFTON
Mailing Address - State:VT
Mailing Address - Zip Code:05146-9768
Mailing Address - Country:US
Mailing Address - Phone:802-843-2368
Mailing Address - Fax:
Practice Address - Street 1:1435 CHESTER RD
Practice Address - Street 2:
Practice Address - City:GRAFTON
Practice Address - State:VT
Practice Address - Zip Code:05146-9768
Practice Address - Country:US
Practice Address - Phone:802-843-2368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-01
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT072.0000209225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT072.0000209OtherSTATE OF VERMONT OCCUPATIONAL THERAPY LICENSE