Individual
JESSICA SOUSA CARVALHO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
31 LUPI CT, SUITE 150, PALM COAST, FL 32137-4761
(386) 447-0011
(386) 447-0161
Mailing address
31 LUPI CT, SUITE 150, PALM COAST, FL 32137-4761
(386) 447-0011
(386) 447-0161
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA12553
FL
Other
Enumeration date
03/13/2014
Last updated
03/13/2014
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