Provider Demographics
NPI:1013725225
Name:DAVIDSON, MAUREEN ELIZABETH (OTR/L)
Entity type:Individual
Prefix:MS
First Name:MAUREEN
Middle Name:ELIZABETH
Last Name:DAVIDSON
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MISS
Other - First Name:MAUREEN
Other - Middle Name:ELIZABETH
Other - Last Name:BARROW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 64
Mailing Address - Street 2:
Mailing Address - City:HARTWICK
Mailing Address - State:NY
Mailing Address - Zip Code:13348-0064
Mailing Address - Country:US
Mailing Address - Phone:607-437-3366
Mailing Address - Fax:
Practice Address - Street 1:3 CHENANGO RD
Practice Address - Street 2:
Practice Address - City:EDMESTON
Practice Address - State:NY
Practice Address - Zip Code:13335-2314
Practice Address - Country:US
Practice Address - Phone:607-965-8377
Practice Address - Fax:607-965-8655
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-19
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029797225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist