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Individual

MRS. DONNA GERALYN RANEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTRL

Contact information

Practice address
6306 BRIDGEVISTA DR, PREMIER OCCUPATIONAL THERAPY SERVICES, LLC, LITHIA, FL 33547-4871
(813) 326-5194
Mailing address
6306 BRIDGEVISTA DR, PREMIER OCCUPATIONAL THERAPY SERVICES, LLC, LITHIA, FL 33547-4871
(813) 326-5194

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT11542
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
355651
WELLCARE
FL
05
889982000
FL
01
Z072V
BCBS
FL
Enumeration date
01/09/2007
Last updated
01/15/2015
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