Provider Demographics
NPI:1942657283
Name:MULCAHEY OCCUPATIONAL THERAPY, LLC
Entity Type:Organization
Organization Name:MULCAHEY OCCUPATIONAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MULCAHEY
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:503-956-6686
Mailing Address - Street 1:PO BOX 719
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:RI
Mailing Address - Zip Code:02809-0719
Mailing Address - Country:US
Mailing Address - Phone:508-557-1442
Mailing Address - Fax:508-557-1462
Practice Address - Street 1:621 LINCOLN ST
Practice Address - Street 2:UNIT 3
Practice Address - City:SEEKONK
Practice Address - State:MA
Practice Address - Zip Code:02771-1718
Practice Address - Country:US
Practice Address - Phone:508-557-1442
Practice Address - Fax:508-557-1462
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-17
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5258261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy