Provider Demographics
NPI:1912020868
Name:DORSEY, NANCY MENDILLO (OT)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:MENDILLO
Last Name:DORSEY
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 1:5 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-8320
Mailing Address - Country:US
Mailing Address - Phone:401-732-4046
Mailing Address - Fax:
Practice Address - Street 1:5 9TH AVE
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-8320
Practice Address - Country:US
Practice Address - Phone:401-732-4046
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI00064225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist