Individual
COURTNEY CELESTE FOUST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1725 HERMITAGE BLVD, TALLAHASSEE, FL 32308-7709
(850) 325-6301
Mailing address
1725 HERMITAGE BLVD, TALLAHASSEE, FL 32308-7709
(850) 325-6301
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
17833
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018131500
—
FL
01
—
OT17833
STATE OF FLORIDA OCCUPATIONAL THERAPY LICENSE
FL
Enumeration date
07/12/2016
Last updated
10/21/2019
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