MEDICARE: MS. CATHI N BROWN MOT, OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	OT 11752	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396761029
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CATHI N BROWN MOT, OTR/L

Provider Business Mailing Address
First Line	:	883 SW CUMORAH HILL ST
Second Line	:
City	:	FORT WHITE
State	:	FL
Zip	:	32038-3741
Country	:	US
Telephone Number	:	386-365-2788
Fax Number	:	386-961-9479

Provider Business Practice Location Address
First Line	:	883 SW CUMORAH HILL ST
Second Line	:
City	:	FORT WHITE
State	:	FL
Zip	:	32038-3741
Country	:	US
Telephone Number	:	386-365-2788
Fax Number	:	386-961-9479

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2006
Last Update Date	:	07/08/2007

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