Provider Demographics
NPI:1760529747
Name:HORAN, MARY ANN (OTL)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:ANN
Last Name:HORAN
Suffix:
Gender:F
Credentials:OTL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:891 FAULKWOOD CT
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34232-2549
Mailing Address - Country:US
Mailing Address - Phone:941-925-6313
Mailing Address - Fax:941-925-6320
Practice Address - Street 1:5881 RAND BLVD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34238-5115
Practice Address - Country:US
Practice Address - Phone:941-927-8805
Practice Address - Fax:941-925-6320
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 2356225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist