Individual
DANIELA MARISOL MABRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTA
Contact information
Practice address
1935 STATE ROAD 436 STE 1005, WINTER PARK, FL 32792-2244
(407) 629-9455
(407) 629-9438
Mailing address
5031 LOBLOLLY BAY LN, ORLANDO, FL 32829-8731
(480) 612-2617
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
18171
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M160173897970
DRIVER'S LICENSE
FL
Enumeration date
03/25/2021
Last updated
03/25/2021
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