Individual
KRISTEN HUMPHREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3603 W GRANADA ST, TAMPA, FL 33629-6917
(239) 823-5811
Mailing address
3603 W GRANADA ST, TAMPA, FL 33629-6917
(813) 399-0722
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
17239
FL
Other
Enumeration date
05/31/2016
Last updated
05/31/2016
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