Individual
LISA DANIELS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
351 SW STATE ROAD 24, OTTER CREEK, FL 32683
(352) 486-3607
Mailing address
PO BOX 86, OTTER CREEK, FL 32683-0086
(352) 486-3607
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
FL
Other
Enumeration date
02/22/2022
Last updated
02/24/2022
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