Organization
LIVE LIFE WELL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BETTINA B BOURDA OTR/L (OCCUPATIONAL THERAPIST)
(713) 385-0782
Entity
Organization
Contact information
Practice address
424 E CENTRAL BLVD, 378, ORLANDO, FL 32801-1923
(713) 385-0782
Mailing address
424 E CENTRAL BLVD, 378, ORLANDO, FL 32801-1923
Taxonomy
Speciality
Code
Description
License number
State
225XM0800X
Mental Health Occupational Therapist
Primary
—
—
Other
Enumeration date
08/16/2012
Last updated
08/16/2012
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