Individual
COLETTE Y FREDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3680 MIDDLEBROOK DR, ORANGE PARK, FL 32065-5543
(904) 716-0235
Mailing address
3680 MIDDLEBROOK DR, ORANGE PARK, FL 32065-5543
(904) 716-0235
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT15674
FL
Other
Enumeration date
03/05/2013
Last updated
03/05/2013
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