Provider Demographics
NPI:1013473206
Name:ALLENSWORTH, MADELYN CLAIRE (OTR/L)
Entity type:Individual
Prefix:MISS
First Name:MADELYN
Middle Name:CLAIRE
Last Name:ALLENSWORTH
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:MADELYN
Other - Middle Name:CLAIRE
Other - Last Name:BURLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:22042 SW 93RD PL
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33190-1230
Mailing Address - Country:US
Mailing Address - Phone:305-790-2402
Mailing Address - Fax:
Practice Address - Street 1:16860 SW 137TH AVE APT 424
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33177-2471
Practice Address - Country:US
Practice Address - Phone:305-790-2402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-13
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL19813225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist