Individual
EVELYN GAUNTLETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1347 SUNSET AVE, LAKELAND, FL 33801-6544
(305) 608-3461
Mailing address
1347 SUNSET AVE, LAKELAND, FL 33801-6544
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA17638
FL
Other
Enumeration date
12/29/2020
Last updated
12/29/2020
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