Individual
LAURA ANN BOUSSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
2001 83RD AVE N LOT 5030, ST PETERSBURG, FL 33702-3932
(248) 420-3525
Mailing address
2001 83RD AVE N LOT 5030, ST PETERSBURG, FL 33702-3932
(248) 420-3525
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
17692
FL
224Z00000X
Occupational Therapy Assistant
5202007345
MI
Other
Enumeration date
09/30/2012
Last updated
02/17/2022
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