MEDICARE: MS. DOREEN M DUGGAN OTR

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	OT9462	FL

General Provider Information

NPI Number	:	1841209608
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DOREEN M DUGGAN OTR

Provider Business Mailing Address
First Line	:	1823 N J ST
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33460-6541
Country	:	US
Telephone Number	:	561-859-9221
Fax Number	:	561-859-9221

Provider Business Practice Location Address
First Line	:	1823 N J ST
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33460-6541
Country	:	US
Telephone Number	:	561-859-9221
Fax Number	:	561-859-9221

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

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

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