Provider Demographics
NPI:1699976712
Name:VANDEPUTTE, SANDY (OTR)
Entity type:Individual
Prefix:
First Name:SANDY
Middle Name:
Last Name:VANDEPUTTE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 MANOMET POINT RD
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-1133
Mailing Address - Country:US
Mailing Address - Phone:508-224-3007
Mailing Address - Fax:508-224-0831
Practice Address - Street 1:17 CHIPMAN WAY
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:MA
Practice Address - Zip Code:02364-1039
Practice Address - Country:US
Practice Address - Phone:781-336-5107
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4074225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist