Provider Demographics
NPI:1386711851
Name:CORREIA, LINDA (OTRL)
Entity type:Individual
Prefix:MISS
First Name:LINDA
Middle Name:
Last Name:CORREIA
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 HARBORVIEW AVE
Mailing Address - Street 2:APT 3
Mailing Address - City:BRISTOL
Mailing Address - State:RI
Mailing Address - Zip Code:02809-1708
Mailing Address - Country:US
Mailing Address - Phone:401-432-6800
Mailing Address - Fax:401-444-8270
Practice Address - Street 1:593 EDDY ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-4923
Practice Address - Country:US
Practice Address - Phone:401-432-6800
Practice Address - Fax:401-444-8270
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2013-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIOT01025225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist