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Individual

TERRA LEAHANN SWENSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
COTA, CLT

Contact information

Practice address
250 W INDIANTOWN RD STE 106, JUPITER, FL 33458-3549
(561) 768-9984
Mailing address
14105 CALOOSA BLVD, WEST PALM BEACH, FL 33418-8633
(561) 722-7510

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA16775
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
OTA16775
PROFESSIONAL LICENSE
FL
Enumeration date
11/02/2018
Last updated
06/09/2022
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