Individual
ANNE IANNICCHERI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1583 MAXIM AVE, PORT ST LUCIE, FL 34952
(772) 361-5061
Mailing address
1583 MAXIM AVE, PORT ST LUCIE, FL 34952
(772) 361-5061
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT12347
FL
Other
Enumeration date
01/08/2009
Last updated
09/01/2010
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