Provider Demographics
NPI:1629341235
Name:HILTON, MAGGIE LYN (OT)
Entity Type:Individual
Prefix:
First Name:MAGGIE
Middle Name:LYN
Last Name:HILTON
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:MAGGIE
Other - Middle Name:LYN
Other - Last Name:MUTCHMIK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5209 SUMMERWOOD CT
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-3451
Mailing Address - Country:US
Mailing Address - Phone:941-232-0665
Mailing Address - Fax:941-343-9402
Practice Address - Street 1:5209 SUMMERWOOD CT
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-3451
Practice Address - Country:US
Practice Address - Phone:941-232-0665
Practice Address - Fax:941-343-9402
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-13
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT8415225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist