Individual
LAQUAIL POWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
2202 W OAK AVE, PLANT CITY, FL 33563-7222
(813) 754-3761
Mailing address
11507 DR MARTIN LUTHER KING JR BLVD UNIT 23, MANGO, FL 33550-7001
(727) 265-1098
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA17671
FL
Other
Enumeration date
09/20/2021
Last updated
09/23/2021
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