Individual
CHRISTINE PETACCIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS OTR/L
Contact information
Practice address
137 S COURTENAY PKWY APT 1379, MERRITT ISLAND, FL 32952-4843
(321) 298-7025
Mailing address
137 S COURTENAY PKWY APT 1379, MERRITT ISLAND, FL 32952-4843
(321) 298-7025
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
46TR00306500
NJ
225X00000X
Occupational Therapist
Primary
OT14854
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M8066
FL HF MEDICARE
FL
Enumeration date
02/21/2018
Last updated
11/11/2020
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