Provider Demographics
NPI:1841209608
Name:DUGGAN, DOREEN M (OTR)
Entity Type:Individual
Prefix:MS
First Name:DOREEN
Middle Name:M
Last Name:DUGGAN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1823 N J ST
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33460-6541
Mailing Address - Country:US
Mailing Address - Phone:561-859-9221
Mailing Address - Fax:561-859-9221
Practice Address - Street 1:1823 N J ST
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33460-6541
Practice Address - Country:US
Practice Address - Phone:561-859-9221
Practice Address - Fax:561-859-9221
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT9462225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ0488Medicare ID - Type UnspecifiedPART B - OT