Provider Demographics
NPI:1275395154
Name:MAGRO, ANNETTE MARIA (OTD, OTR/L)
Entity Type:Individual
Prefix:
First Name:ANNETTE
Middle Name:MARIA
Last Name:MAGRO
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1807 MORNING SUN CIR
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-2962
Mailing Address - Country:US
Mailing Address - Phone:205-903-3531
Mailing Address - Fax:
Practice Address - Street 1:651 MAIN ST
Practice Address - Street 2:
Practice Address - City:GARDENDALE
Practice Address - State:AL
Practice Address - Zip Code:35071-2789
Practice Address - Country:US
Practice Address - Phone:205-903-3531
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-26
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL6178225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics