Provider Demographics
NPI:1205274099
Name:CULLIGAN, MARY PATRICIA (OTR/L, SWC)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:PATRICIA
Last Name:CULLIGAN
Suffix:
Gender:F
Credentials:OTR/L, SWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:335 HOOHANA ST STE F
Mailing Address - Street 2:
Mailing Address - City:KAHULUI
Mailing Address - State:HI
Mailing Address - Zip Code:96732-3527
Mailing Address - Country:US
Mailing Address - Phone:808-446-2032
Mailing Address - Fax:833-565-3144
Practice Address - Street 1:335 HOOHANA ST STE F
Practice Address - Street 2:
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732-3527
Practice Address - Country:US
Practice Address - Phone:760-473-7881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-13
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA970225XF0002X
HIOT-2290225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XF0002XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistFeeding, Eating & Swallowing