Provider Demographics
NPI:1871807297
Name:CORRIGAN, MARILYN ADAIR (OT)
Entity type:Individual
Prefix:
First Name:MARILYN
Middle Name:ADAIR
Last Name:CORRIGAN
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:MARILYN
Other - Middle Name:ADAIR
Other - Last Name:MCDOWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:26 RACETRACK RD NW STE E
Mailing Address - Street 2:
Mailing Address - City:FORT WALTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32547-1640
Mailing Address - Country:US
Mailing Address - Phone:248-644-3920
Mailing Address - Fax:855-978-2212
Practice Address - Street 1:26 RACETRACK RD NW
Practice Address - Street 2:
Practice Address - City:FT WALTON BCH
Practice Address - State:FL
Practice Address - Zip Code:32547-1640
Practice Address - Country:US
Practice Address - Phone:850-374-3465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-27
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201001476225X00000X
FLOT22394225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist