Individual
KATIE AMANDA SHIRK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2080 W EAU GALLIE BLVD STE A, MELBOURNE, FL 32935-3185
(407) 694-3603
Mailing address
741 COBBLESTONE LN NE, PALM BAY, FL 32905-5427
(304) 834-9535
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT25955
FL
Other
Enumeration date
02/27/2025
Last updated
02/27/2025
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