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Individual

MRS. ELAINE MIDDLETON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
1111 LAS GALLINAS AVE, SAN RAFAEL, CA 94903-1843
(415) 485-2435
Mailing address
1111 LAS GALLINAS AVE, SAN RAFAEL, CA 94903-1843
(415) 485-2435

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
OT10642
FL
225X00000X
Occupational Therapist
Primary
19700
CA
225X00000X
Occupational Therapist
Primary
OT10642
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
888137500
FL
Enumeration date
02/06/2007
Last updated
04/30/2026
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