Individual
MRS. KOURTNI WALTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS,OTR/L
Contact information
Practice address
315 NW SHIRLEY CT, PORT SAINT LUCIE, FL 34986-3596
(954) 465-4467
Mailing address
315 NW SHIRLEY CT, PORT SAINT LUCIE, FL 34986-3596
(954) 465-4467
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT 11861
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890876100
—
FL
Enumeration date
08/17/2010
Last updated
07/24/2024
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