Provider Demographics
NPI:1740303478
Name:MCCABE, MICHELINE (OT)
Entity type:Individual
Prefix:MS
First Name:MICHELINE
Middle Name:
Last Name:MCCABE
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 1:1515 E BROWARD BLVD APT 405
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33301-2142
Mailing Address - Country:US
Mailing Address - Phone:561-846-9414
Mailing Address - Fax:
Practice Address - Street 1:238 CITY VIEW DR
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33311-9120
Practice Address - Country:US
Practice Address - Phone:954-661-5695
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT11673225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist