Organization
FUNCTIONAL KIDS THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOAN T WARREN MHS, OTR/L (MGRM)
(904) 838-0800
Entity
Organization
Contact information
Practice address
1232 HARBOUR TOWN DR, ORANGE PARK, FL 32065-2562
(904) 838-0800
(904) 291-2426
Mailing address
1232 HARBOUR TOWN DR, ORANGE PARK, FL 32065-2562
(904) 838-0800
(904) 291-2426
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT9446
FL
Other
Enumeration date
08/27/2012
Last updated
05/19/2014
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