Individual
DOAA TALEES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
312 NESBIT ST, SUITE 112, PUNTA GORDA, FL 33950-3804
(941) 639-8273
(941) 639-8294
Mailing address
842 PLACID LAKE DR, OSPREY, FL 34229-6833
(941) 286-8473
(941) 639-8294
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
PT18988
FL
225100000X
Physical Therapist
Primary
PT18988
FL
Other
Enumeration date
12/01/2011
Last updated
11/26/2017
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