Provider Demographics
NPI:1538355649
Name:JONES, MARY LOUISE (OTR/L,)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:LOUISE
Last Name:JONES
Suffix:
Gender:F
Credentials:OTR/L,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6912 4TH AVENUE DR NW
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209-2222
Mailing Address - Country:US
Mailing Address - Phone:941-224-8936
Mailing Address - Fax:941-794-3563
Practice Address - Street 1:6912 4TH AVENUE DR NW
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-2222
Practice Address - Country:US
Practice Address - Phone:941-224-8936
Practice Address - Fax:941-794-3563
Is Sole Proprietor?:No
Enumeration Date:2007-09-21
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT3561225X00000X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist