Individual
GRACE ELISIA HORGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MOT, OTR/L
Contact information
Practice address
841 PRUDENTIAL DR STE 140, JACKSONVILLE, FL 32207-8363
(904) 346-0394
Mailing address
841 PRUDENTIAL DR STE 140, JACKSONVILLE, FL 32207-8363
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT13458
FL
Other
Enumeration date
04/25/2012
Last updated
04/25/2012
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