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Individual

LENSSA AGA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
5333 VINELAND RD, ORLANDO, FL 32811-7648
(678) 653-6772
Mailing address
5333 VINELAND RD, ORLANDO, FL 32811-7648

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
OT 009168
OH
225X00000X
Occupational Therapist
Primary
OT 10934
FL

Other

Enumeration date
09/07/2016
Last updated
09/07/2016
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