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General NPI Number Information
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NPI Number | 1154292035
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Entity Type | Individual
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Provider Name | CHARLIE NELL TOOTHMAN OTR/L, CLT
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Gender | Female
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Dates
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Enumeration Date | 09/15/2025
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Last Update Date | 09/15/2025
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Provider Practice Location Address
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Address Line | 1000 MAR WALT DR
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City | FORT WALTON BEACH
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State | FL
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Zip | 32547-6708
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Country | US
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Telephone | 850-862-1111
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Fax |
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Provider Business Mailing Address
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Address Line | 1100 CIRCLE 75 PKWY SE STE 1400
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City | ATLANTA
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State | GA
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Zip | 30339-3067
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Country | US
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Telephone | 678-403-3555
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT15101
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License Number State | FL
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