Provider Demographics
NPI:1023341302
Name:CAPUCO, MARTHA (OTR/L)
Entity type:Individual
Prefix:
First Name:MARTHA
Middle Name:
Last Name:CAPUCO
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 1:124 HALL ST
Mailing Address - Street 2:SUITE H
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-3478
Mailing Address - Country:US
Mailing Address - Phone:603-228-9160
Mailing Address - Fax:603-224-2776
Practice Address - Street 1:124 HALL ST
Practice Address - Street 2:SUITE H
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-3478
Practice Address - Country:US
Practice Address - Phone:603-228-9160
Practice Address - Fax:603-224-2776
Is Sole Proprietor?:No
Enumeration Date:2009-09-17
Last Update Date:2009-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH767225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics