Individual
MRS. BREENDA PETROPOULOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1422 SAN MARCO BLVD, JACKSONVILLE, FL 32207-8536
(904) 398-4133
Mailing address
2669 SHANNON ST, ORANGE PARK, FL 32065-6343
(904) 312-1310
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA10116
FL
Other
Enumeration date
06/14/2007
Last updated
07/08/2007
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