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Individual

MS. KRISTY L SCHABACKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSOTRL

Contact information

Practice address
455 W WARREN AVE STE 200, LONGWOOD, FL 32750-4038
(407) 260-0551
Mailing address
455 W WARREN AVE STE 200, LONGWOOD, FL 32750-4038
(407) 260-0551

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
11550
FL
225X00000X
Occupational Therapist
Primary
OT11550
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1669679650
FL
01
OT11550
OT LICENSE
FL
Enumeration date
07/02/2007
Last updated
01/31/2022
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