Individual
MRS. JODI MELISSA FISKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
6287 VIA PALLADIUM, BOCA RATON, FL 33433-3847
(561) 447-8632
Mailing address
6287 VIA PALLADIUM, BOCA RATON, FL 33433-3847
(561) 447-8632
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
9907
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000857200
—
FL
05
—
886534500
—
FL
Enumeration date
02/11/2009
Last updated
12/28/2009
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