Provider Demographics
NPI:1548753981
Name:HANRAHAN, CAITLIN (OTR/L)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:
Last Name:HANRAHAN
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 1:28C MOODUS LEESVILLE RD
Mailing Address - Street 2:
Mailing Address - City:MOODUS
Mailing Address - State:CT
Mailing Address - Zip Code:06469-1030
Mailing Address - Country:US
Mailing Address - Phone:860-885-8308
Mailing Address - Fax:
Practice Address - Street 1:30 BOKUM RD
Practice Address - Street 2:
Practice Address - City:ESSEX
Practice Address - State:CT
Practice Address - Zip Code:06426-1510
Practice Address - Country:US
Practice Address - Phone:860-767-7201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-11
Last Update Date:2018-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT4955225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist