Individual
HEATHER ELIZABETH CONKLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
15 CYPRESS BRANCH WAY STE 207D, PALM COAST, FL 32164-8414
(386) 585-5955
(386) 585-7017
Mailing address
1 BLAKEMORE DR, PALM COAST, FL 32137-7336
(772) 485-1056
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
17363
FL
Other
Enumeration date
07/26/2019
Last updated
07/26/2019
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