Individual
DENISE WIEDEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1982 ROCKLEDGE BLVD, SUITE 102, ROCKLEDGE, FL 32955-3760
(321) 631-5366
Mailing address
1982 ROCKLEDGE BLVD, SUITE 102, ROCKLEDGE, FL 32955-3760
(321) 631-5366
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT9503
FL
Other
Enumeration date
06/16/2009
Last updated
06/16/2009
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