Individual
HEATHER HALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6301 N CANOE CREEK RD, KENANSVILLE, FL 34739-9625
(407) 908-4654
Mailing address
6301 N CANOE CREEK RD, KENANSVILLE, FL 34739-9625
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OAT14768
FL
Other
Enumeration date
09/23/2015
Last updated
09/23/2015
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