Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XF0002X | Feeding, Eating & Swallowing | OT11830 | FL |
N | 225XM0800X | Mental Health | OT11830 | FL |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | OT11830 | FL |
Y | 225XP0200X | Occupational Therapist - Pediatrics | OT11830 | FL |
NPI | 1205068657 |
---|---|
Provider Name | Ms. Mary Catherine Cunningham-Portner |
First Address | Weston, FL 33331-3634 |
Second Address | Weston, FL 33331-3634 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2009 |
Last Update Date | 28/08/2009 |