Individual
KIRSTEN FAITH GROWDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
11401 OLD SAINT AUGUSTINE RD, JACKSONVILLE, FL 32258-1402
(904) 260-1818
Mailing address
14805 CAPE DR E, JACKSONVILLE, FL 32226-1205
(985) 855-6457
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
17781
FL
224Z00000X
Occupational Therapy Assistant
Primary
A02713
MD
Other
Enumeration date
02/04/2019
Last updated
04/19/2021
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