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Individual

KRISTI RAE GRAINGER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
113 W CHAPMAN RD, OVIEDO, FL 32765-8895
(407) 579-9181
Mailing address
11461 LAKE BUTLER BLVD, WINDERMERE, FL 34786-7814
(407) 579-9181

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA19235
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0735932081
FL
Enumeration date
12/19/2022
Last updated
12/19/2022
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