Individual
THERESA REIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
142 MAGNOLIA DR, ORMOND BEACH, FL 32176-8115
(508) 951-3813
Mailing address
142 MAGNOLIA DRIVE, ORMOND BEACH, FL 32176
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA11347
FL
Other
Enumeration date
03/16/2011
Last updated
03/16/2011
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