Individual
VICTORIA SUE BLANCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
4132 SW 149TH PL, MIAMI, FL 33185-4168
(305) 753-8253
Mailing address
4132 SW 149TH PL, MIAMI, FL 33185-4168
(305) 753-8253
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
12595
FL
Other
Enumeration date
08/28/2023
Last updated
08/28/2023
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