Provider Demographics
NPI:1912237884
Name:PRATT, RUTH DONNA (COTA/L)
Entity type:Individual
Prefix:
First Name:RUTH
Middle Name:DONNA
Last Name:PRATT
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 LANGDON RD
Mailing Address - Street 2:
Mailing Address - City:CHARLESTOWN
Mailing Address - State:NH
Mailing Address - Zip Code:03603-5110
Mailing Address - Country:US
Mailing Address - Phone:603-445-5280
Mailing Address - Fax:
Practice Address - Street 1:1020 LANGDON RD
Practice Address - Street 2:
Practice Address - City:CHARLESTOWN
Practice Address - State:NH
Practice Address - Zip Code:03603-5110
Practice Address - Country:US
Practice Address - Phone:603-445-5280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-28
Last Update Date:2009-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT073-0000007225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist