Provider Demographics
NPI:1447263934
Name:MULDOWNEY, COLLEEN M (MS, OTR/L)
Entity type:Individual
Prefix:MISS
First Name:COLLEEN
Middle Name:M
Last Name:MULDOWNEY
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5122 MANCHESTER CT APT 106
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34685-6136
Mailing Address - Country:US
Mailing Address - Phone:610-368-9586
Mailing Address - Fax:
Practice Address - Street 1:3602 W SAN JUAN ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33629-6922
Practice Address - Country:US
Practice Address - Phone:813-833-0090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2020-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC006225L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist