Individual
EDITA JANCAUSKAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2125 SW SUSSET LN, PORT ST LUCIE, FL 34953-2300
(708) 717-4266
Mailing address
2125 SW SUSSET LN, PORT ST LUCIE, FL 34953-2300
(708) 717-4266
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT14561
FL
Other
Enumeration date
07/01/2011
Last updated
07/01/2011
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