Provider Demographics
NPI:1487930053
Name:FLYNN, CATHERINE LYNN (OTR)
Entity type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:LYNN
Last Name:FLYNN
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 1:15720 SW 84TH CT
Mailing Address - Street 2:
Mailing Address - City:PALMETTO BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-2124
Mailing Address - Country:US
Mailing Address - Phone:305-342-5191
Mailing Address - Fax:
Practice Address - Street 1:15720 SW 84TH CT
Practice Address - Street 2:
Practice Address - City:PALMETTO BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-2124
Practice Address - Country:US
Practice Address - Phone:305-342-5191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-27
Last Update Date:2011-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 1935225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist