Individual
MAYRA TORRES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
611 S 13TH ST, FORT PIERCE, FL 34950-4054
(772) 464-5262
Mailing address
5255 NW GAMMA ST, PORT ST LUCIE, FL 34986-2708
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA11765
FL
Other
Enumeration date
10/24/2011
Last updated
10/24/2011
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