Individual
KATHLEEN BASHORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8057 LE HAVRE DR N, JACKSONVILLE, FL 32277-0902
(904) 728-4603
Mailing address
8057 LE HAVRE DR N, JACKSONVILLE, FL 32277-0902
(904) 728-4603
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA 15071
FL
Other
Enumeration date
03/18/2016
Last updated
05/09/2017
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