Provider Demographics
NPI:1891160263
Name:NORTHRUP, PATRICIA SWEENEY (BS, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:SWEENEY
Last Name:NORTHRUP
Suffix:
Gender:F
Credentials:BS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 ANGEL AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH KINGSTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02852-4703
Mailing Address - Country:US
Mailing Address - Phone:401-569-9385
Mailing Address - Fax:
Practice Address - Street 1:40 ANGEL AVE
Practice Address - Street 2:
Practice Address - City:NORTH KINGSTOWN
Practice Address - State:RI
Practice Address - Zip Code:02852-4703
Practice Address - Country:US
Practice Address - Phone:401-569-9385
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-10
Last Update Date:2015-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI00987225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist