Provider Demographics
NPI:1053103325
Name:DUPUIS, RENEE LUCILLE (OTR/L)
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:LUCILLE
Last Name:DUPUIS
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 1:35 STOREY AVE
Mailing Address - Street 2:
Mailing Address - City:COVENTRY
Mailing Address - State:CT
Mailing Address - Zip Code:06238-2446
Mailing Address - Country:US
Mailing Address - Phone:860-614-3374
Mailing Address - Fax:
Practice Address - Street 1:35 STOREY AVE
Practice Address - Street 2:
Practice Address - City:COVENTRY
Practice Address - State:CT
Practice Address - Zip Code:06238-2446
Practice Address - Country:US
Practice Address - Phone:860-614-3374
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-21
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT6588225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist