Provider Demographics
NPI:1053901637
Name:TIMOTHEE, FLORALDINE (OTR)
Entity type:Individual
Prefix:
First Name:FLORALDINE
Middle Name:
Last Name:TIMOTHEE
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 1:8101 BOAT CLUB RD STE 330
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76179-3633
Mailing Address - Country:US
Mailing Address - Phone:682-498-3928
Mailing Address - Fax:214-935-2457
Practice Address - Street 1:201 BILLINGS ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76010-5401
Practice Address - Country:US
Practice Address - Phone:682-800-4620
Practice Address - Fax:214-935-2457
Is Sole Proprietor?:No
Enumeration Date:2021-01-19
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX124288225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist