Provider Demographics
NPI:1447648621
Name:DINNEEN, BRIDGET ANN (OTR)
Entity type:Individual
Prefix:MRS
First Name:BRIDGET
Middle Name:ANN
Last Name:DINNEEN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 E LASLEY ST
Mailing Address - Street 2:
Mailing Address - City:SAINT MARYS
Mailing Address - State:KS
Mailing Address - Zip Code:66536-1739
Mailing Address - Country:US
Mailing Address - Phone:785-437-2008
Mailing Address - Fax:
Practice Address - Street 1:203 E LASLEY ST
Practice Address - Street 2:
Practice Address - City:SAINT MARYS
Practice Address - State:KS
Practice Address - Zip Code:66536-1739
Practice Address - Country:US
Practice Address - Phone:785-437-2008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-23
Last Update Date:2014-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS17-02491225XG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontology