Provider Demographics
NPI:1841538188
Name:CORDIER, PRINCESS (MSOT)
Entity type:Individual
Prefix:MRS
First Name:PRINCESS
Middle Name:
Last Name:CORDIER
Suffix:
Gender:F
Credentials:MSOT
Other - Prefix:
Other - First Name:PRINCESS
Other - Middle Name:DENISE
Other - Last Name:CORDIER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTR
Mailing Address - Street 1:447 ORBY ST
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32534-9619
Mailing Address - Country:US
Mailing Address - Phone:850-261-1111
Mailing Address - Fax:
Practice Address - Street 1:447 ORBY ST
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32534-9619
Practice Address - Country:US
Practice Address - Phone:850-261-1111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-22
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT15616225XP0200X
FL15616225X00000X
225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist