Individual
GABRIELLE GRACE BEASLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1935 STATE ROAD 436 STE 500, WINTER PARK, FL 32792-2244
(407) 629-9455
Mailing address
188 EASTSIDE LN, OSTEEN, FL 32764-9428
(407) 947-1715
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA17863
FL
Other
Enumeration date
08/02/2020
Last updated
08/02/2020
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