MEDICARE: JANET MARIE MADDEN OCCUPATIONAL THERAPI

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	286	CA

General Provider Information

NPI Number	:	1518943182
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANET MARIE MADDEN OCCUPATIONAL THERAPI

Provider Business Mailing Address
First Line	:	PSC 482 BOX 2579
Second Line	:
City	:	FPO
State	:	AP
Zip	:	96362
Country	:	US
Telephone Number	:	816117437494
Fax Number	:

Provider Business Practice Location Address
First Line	:	PSC 482
Second Line	:	BOX 2579
City	:	FPO
State	:	AP
Zip	:	96362-9998
Country	:	US
Telephone Number	:	816117437494
Fax Number	:

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

Provider Enumeration Date	:	12/15/2005
Last Update Date	:	09/10/2008

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