Provider Demographics
NPI:1255502878
Name:PUTMAN, DORINDA (COTA/L)
Entity Type:Individual
Prefix:MRS
First Name:DORINDA
Middle Name:
Last Name:PUTMAN
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 COTTONWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MUSCLE SHOALS
Mailing Address - State:AL
Mailing Address - Zip Code:35661-5607
Mailing Address - Country:US
Mailing Address - Phone:256-335-4242
Mailing Address - Fax:
Practice Address - Street 1:160 COTTONWOOD DR
Practice Address - Street 2:
Practice Address - City:MUSCLE SHOALS
Practice Address - State:AL
Practice Address - Zip Code:35661-5607
Practice Address - Country:US
Practice Address - Phone:256-335-4242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-23
Last Update Date:2008-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2673224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant