Individual
AGATA S MACDONALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
4 JACKSON ST NE, FORT WALTON BEACH, FL 32548-4925
(850) 862-7227
Mailing address
1473 GULF WINDS DR, GULF BREEZE, FL 32563-1929
(850) 932-2673
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT 9614
FL
Other
Enumeration date
07/27/2006
Last updated
07/08/2007
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