Individual
MRS. KRISTEN IRENE MACCHIAROLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1132 CAPRICORN BLVD, PUNTA GORDA, FL 33983
(941) 286-5840
Mailing address
1510 N BLUFF ST, FULTON, MO 65251-2352
(573) 642-0202
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA12587
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1275715401
—
FL
Enumeration date
11/29/2007
Last updated
11/23/2021
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