Individual
JAESEN PETRETTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
9350 CAMELOT DR, FORT MYERS, FL 33919-7980
(239) 839-3408
Mailing address
9350 CAMELOT DR, FORT MYERS, FL 33919-7980
(239) 839-3408
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT 10199
FL
Other
Enumeration date
01/15/2007
Last updated
10/18/2007
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