Individual
KRISTINE FRANCES RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
16 FERNMILL LN, PALM COAST, FL 32137-9104
(386) 503-0921
Mailing address
16 FERNMILL LN, PALM COAST, FL 32137-9104
(386) 503-0921
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA 14459
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
81063086701
MED IMPACT
FL
Enumeration date
05/26/2015
Last updated
05/26/2015
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