Individual
TREVOR RYAN RAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
400 NORTH LAKE HOWARD DRIVE, WINTER HAVEN, FL 33881
(863) 875-3599
Mailing address
470 CITI CTR ST # 1220, WINTER HAVEN, FL 33880-3425
(863) 662-2179
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
19228
FL
Other
Enumeration date
03/06/2023
Last updated
07/01/2024
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