Individual
MS. MARY D HUSZCZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR L
Contact information
Practice address
345 CAPTIVA DR, PONTE VEDRA, FL 32081-5066
(904) 254-7569
Mailing address
345 CAPTIVA DR, PONTE VEDRA, FL 32081-5066
(904) 254-7569
(904) 302-6270
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
OT 10154
FL
225XP0200X
Pediatric Occupational Therapist
Primary
OT 10154
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
887015200
—
FL
Enumeration date
01/04/2007
Last updated
09/03/2013
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