Individual
MS. JENNIFER GANGI SOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
860 WICKHAM LAKES DR, MELBOURNE, FL 32940-2232
(321) 432-2333
Mailing address
860 WICKHAM LAKES DR, MELBOURNE, FL 32940-2232
(321) 432-2333
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
17838
FL
Other
Enumeration date
06/01/2024
Last updated
06/01/2024
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