Individual
MS. JACQUELINE CHIVERTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
11133 LAKE TAHOE DR, RIVERVIEW, FL 33569-2927
(813) 938-0710
Mailing address
11133 LAKE TAHOE DR, RIVERVIEW, FL 33569-2927
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA 7848
FL
Other
Enumeration date
11/04/2011
Last updated
11/04/2011
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