Provider Demographics
NPI:1669685749
Name:FERRALL, BERNICE ALICE (OT)
Entity Type:Individual
Prefix:MRS
First Name:BERNICE
Middle Name:ALICE
Last Name:FERRALL
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 E COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32301-2528
Mailing Address - Country:US
Mailing Address - Phone:850-521-0800
Mailing Address - Fax:850-521-0800
Practice Address - Street 1:521 E COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32301-2528
Practice Address - Country:US
Practice Address - Phone:850-521-0800
Practice Address - Fax:850-521-0800
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL59225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist