Individual
ASHLEY PEREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
626 N TYNDALL PKWY, PANAMA CITY, FL 32404-6132
(850) 871-6363
Mailing address
PO BOX 96, 166 JULIO RD, GREENSBORO, FL 32330
(850) 556-5870
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA13994
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7548120362
—
FL
Enumeration date
03/31/2015
Last updated
03/31/2015
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