Healthcare Provider Details

I. General information

NPI: 1831789809
Provider Name (Legal Business Name): SYDNEY ERIN O'CONNOR OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2021
Last Update Date: 01/22/2021
Certification Date: 01/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

660 MCQUEEN SMITH RD N STE H
PRATTVILLE AL
36066-7559
US

IV. Provider business mailing address

660 MCQUEEN SMITH RD N STE H
PRATTVILLE AL
36066-7559
US

V. Phone/Fax

Practice location:
  • Phone: 334-350-3362
  • Fax: 833-901-0351
Mailing address:
  • Phone: 334-350-3362
  • Fax: 833-901-0351

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number5501
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: