Individual
THERESA SUNSHINE DELVALLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
501 BURNS AVE, LAKE WALES, FL 33853-3335
(863) 679-3338
(863) 455-7049
Mailing address
920 S LAKESHORE BLVD, LAKE WALES, FL 33853-4222
(863) 660-1215
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
17049
FL
Other
Enumeration date
02/01/2021
Last updated
02/01/2021
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