Individual
MS. HANNAH LIANNE DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
195 MATTIE M KELLY BLVD, DESTIN, FL 32541-2811
(850) 654-4588
Mailing address
19400 NW 66TH AVE, STARKE, FL 32091-5526
(904) 707-4980
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA15755
FL
Other
Enumeration date
07/03/2017
Last updated
07/03/2017
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