Individual
MISS NIOMI MICHELLE RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
2103 LAKE HOLLOWAY BLVD, LAKELAND, FL 33801-6021
(863) 667-8916
Mailing address
2103 LAKE HOLLOWAY BLVD, LAKELAND, FL 33801-6021
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
12673
FL
Other
Enumeration date
12/13/2012
Last updated
12/13/2012
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