Individual
ANGELIA ETHEREDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
31249 COUNTY ROAD 435, SORRENTO, FL 32776-7525
(407) 309-0406
Mailing address
2421 MINNESOTA AVE, WINTER PARK, FL 32789-5335
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA15599
FL
Other
Enumeration date
11/28/2016
Last updated
10/05/2022
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