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Individual
MS. MELINDA C BROADSTONE
Active
Individual
MS. MELINDA C BROADSTONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.T., M.T., CLT
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
MA32767
FL
225X00000X
Occupational Therapist
Primary
OT9352
FL
225XG0600X
Gerontology Occupational Therapist
OT9352
FL
225XN1300X
Neurorehabilitation Occupational Therapist
OT9352
FL
225XP0200X
Pediatric Occupational Therapist
OT9352
FL
Other
Enumeration date
01/14/2010
Last updated
01/14/2010
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