Individual
MRS. LETRACIA NANETTE STREATER-CHISOLM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1215 KINGSLEY AVE, ORANGE PARK, FL 32073-4631
(904) 269-8922
(904) 375-0719
Mailing address
1215 KINGSLEY AVE, ORANGE PARK, FL 32073-4631
(904) 269-8922
(904) 375-0719
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
14864
FL
Other
Enumeration date
06/06/2017
Last updated
07/21/2022
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