Individual
DAESHA J HUERTAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
4411 N HABANA AVE, TAMPA, FL 33614-7211
(877) 787-3430
Mailing address
4712 N EDDY DR, TAMPA, FL 33603-2606
(813) 420-0184
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
15584
FL
Other
Enumeration date
05/24/2019
Last updated
05/24/2019
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