Individual
THERESA M WALSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
2959 W MIDWAY RD, FORT PIERCE, FL 34981-4956
(772) 462-6601
(772) 462-6634
Mailing address
5013 CORSICA SQ, VERO BEACH, FL 32967-7683
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT13782
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT13782
FLORIDA DEPARTMENT OF HEALTH
FL
Enumeration date
02/18/2010
Last updated
02/18/2010
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