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Individual

KERRY MARIE WALSH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
12110 WALDEN WOODS DR, ORLANDO, FL 32826-2231
(407) 579-1719
Mailing address
12110 WALDEN WOODS DR, ORLANDO, FL 32826-2231
(407) 579-1719

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT11296
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8897336
FL
Enumeration date
07/18/2006
Last updated
07/08/2007
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