Individual
MONICA MCNALLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L/ LMT
Contact information
Practice address
109 HAMMOCK CIR, ST AUGUSTINE, FL 32084-1754
(904) 347-5036
Mailing address
109 HAMMOCK CIR, ST AUGUSTINE, FL 32084-1754
(904) 347-5036
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MA7761
FL
174400000X
Specialist
Primary
OTA8030
FL
Other
Enumeration date
09/19/2011
Last updated
09/19/2011
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