Provider Demographics
NPI:1487745550
Name:SPERRAZZA, MARY FRANCES (OTR L)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:FRANCES
Last Name:SPERRAZZA
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 1:27 KILLEN RD
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492-2693
Mailing Address - Country:US
Mailing Address - Phone:203-931-4025
Mailing Address - Fax:203-931-4068
Practice Address - Street 1:114 BOSTON POST RD # 152
Practice Address - Street 2:ERRERA COMMUNITY CARE CENTER
Practice Address - City:WEST HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06516-2043
Practice Address - Country:US
Practice Address - Phone:203-931-4025
Practice Address - Fax:203-931-4068
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000695225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist