Individual
CARISSA SIMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1483 SW BOUGAINVILLEA AVE, PORT SAINT LUCIE, FL 34953-7302
(772) 336-6928
Mailing address
205 E SUGARLAND CIR, CLEWISTON, FL 33440-4214
(863) 244-9863
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA16297
FL
Other
Enumeration date
03/21/2018
Last updated
03/21/2018
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