Individual
MRS. JENNIFER SUZANNE GRAWUNDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT10997
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10638801
CITRUS HEALTHCARE
FL
01
—
2042N
BCBS
FL
01
—
355216
WELLCARE
FL
Enumeration date
02/09/2007
Last updated
07/08/2007
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