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Individual

MRS. AYESHA M HARRIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA/L, CAPS

Contact information

Practice address
13521 STONE POND DR, JACKSONVILLE, FL 32224-1626
(904) 800-9874
Mailing address
PO BOX 17391, JACKSONVILLE, FL 32245-7391
(904) 800-9874

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
224ZE0001X
Environmental Modification Occupational Therapy Assistant
Primary
OTA13216
FL
224ZL0004X
Low Vision Occupational Therapy Assistant
224ZR0403X
Driving and Community Mobility Occupational Therapy Assistant

Other

Enumeration date
12/08/2019
Last updated
12/08/2019
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