Individual
DIVYA DESAI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15175 RUSSELL BRIDGE DR, JACKSONVILLE, FL 32259-7057
(904) 420-9229
Mailing address
15175 RUSSELL BRIDGE DR, JACKSONVILLE, FL 32259-7057
(904) 420-9229
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT 15090
FL
Other
Enumeration date
08/17/2011
Last updated
04/20/2020
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