Individual
ELISABETH GULLETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
9421 W PARK VILLAGE DR, TAMPA, FL 33626-5148
(703) 935-9376
Mailing address
9421 W PARK VILLAGE DR, TAMPA, FL 33626-5148
(703) 935-9376
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT17864
FL
225XP0200X
Pediatric Occupational Therapist
OT 17864
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018697200
—
FL
Enumeration date
09/24/2016
Last updated
08/24/2022
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