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Individual

KRISTINE HAGGARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2788 E FOWLER AVE, TAMPA, FL 33612-6297
(813) 978-1704
Mailing address
19623 WYNDHAM LAKES DR, ODESSA, FL 33556-1703
(813) 920-0971

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3158
LICENSE #
FL
Enumeration date
08/20/2006
Last updated
07/08/2007
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