Provider Demographics
NPI:1275229643
Name:MULLIGAN, ANN (OTD, MSOT, OTR/L)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:MULLIGAN
Suffix:
Gender:F
Credentials:OTD, MSOT, OTR/L
Other - Prefix:DR
Other - First Name:ANN
Other - Middle Name:
Other - Last Name:MULLIGAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTD, MSOT, OTR/L
Mailing Address - Street 1:190 W IRONSTONE RD
Mailing Address - Street 2:
Mailing Address - City:HARRISVILLE
Mailing Address - State:RI
Mailing Address - Zip Code:02830-1626
Mailing Address - Country:US
Mailing Address - Phone:401-258-7343
Mailing Address - Fax:
Practice Address - Street 1:12 MONEY HILL ROAD
Practice Address - Street 2:SUITE B
Practice Address - City:CHEPACHET
Practice Address - State:RI
Practice Address - Zip Code:02814
Practice Address - Country:US
Practice Address - Phone:401-394-9019
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-18
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIOT01694225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist