Individual
MICHELE MASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
245 SERVIA DR, ST JOHNS, FL 32259-2232
(631) 219-6436
Mailing address
245 SERVIA DR, ST JOHNS, FL 32259-2232
(631) 219-6436
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA16557
FL
Other
Enumeration date
09/07/2022
Last updated
09/07/2022
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