Individual
QUYNN MARIE FONSECA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
7101 9TH ST N, ST PETERSBURG, FL 33702-5819
(727) 527-7231
Mailing address
450 FAIRWOOD AVE APT 129, CLEARWATER, FL 33759-3155
(352) 584-2744
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
16611
FL
Other
Enumeration date
12/27/2018
Last updated
12/27/2018
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