Individual
DANIELLE SOUZA FORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
2266 LIBERTY LOOP RD, CANTONMENT, FL 32533-9211
(251) 508-7145
Mailing address
2266 LIBERTY LOOP RD, CANTONMENT, FL 32533-9211
(251) 508-7145
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
14977
FL
Other
Enumeration date
09/04/2018
Last updated
09/04/2018
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