Individual
DESTINY A BRAUDRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L, CLT
Contact information
Practice address
7000 SPYGLASS CT STE 120, VIERA, FL 32940-7948
(321) 241-6543
(321) 241-6513
Mailing address
5026 BRIDGE RD, COCOA, FL 32927-9131
(321) 720-9652
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA16265
FL
Other
Enumeration date
05/15/2018
Last updated
06/28/2023
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