Provider Demographics
NPI:1346765179
Name:FLAHERTY, EVELYN MARGARET (MA)
Entity Type:Individual
Prefix:
First Name:EVELYN
Middle Name:MARGARET
Last Name:FLAHERTY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 XANADU W
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34285-6335
Mailing Address - Country:US
Mailing Address - Phone:941-800-8136
Mailing Address - Fax:
Practice Address - Street 1:900 XANADU W
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34285-6335
Practice Address - Country:US
Practice Address - Phone:941-800-8136
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist