Individual
JANE ANNE ROBERTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, COTA/L
Contact information
Practice address
232 CECELIA DR NW, FORT WALTON BEACH, FL 32548-4714
(860) 303-3527
Mailing address
232 CECELIA DR NW, FORT WALTON BEACH, FL 32548-4714
(860) 303-3527
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
03-893788
CT
224Z00000X
Occupational Therapy Assistant
03-882186
CT
224Z00000X
Occupational Therapy Assistant
OTA 11327
FL
Other
Enumeration date
10/07/2010
Last updated
10/07/2010
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