Individual
MRS. LAURA LEA MACHOL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6410 21ST AVE W, BRADENTON, FL 34209-7854
(941) 798-8417
(941) 798-8389
Mailing address
6410 21ST AVE W, BRADENTON, FL 34209-7854
(941) 798-8417
(941) 798-8389
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
MH 9175
FL
225X00000X
Occupational Therapist
Primary
OT7381
FL
Other
Enumeration date
01/10/2008
Last updated
01/23/2014
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