Individual
MRS. MARIE I PORTFOLIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
336 S POWERLINE RD, DEERFIELD BEACH, FL 33442-8105
(954) 572-5851
Mailing address
336 S POWERLINE RD, DEERFIELD BEACH, FL 33442-8105
(954) 572-5851
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
16082
FL
Other
Enumeration date
01/08/2019
Last updated
01/08/2019
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