Individual
TINA PERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
512 S 11TH ST, LAKE WALES, FL 33853-4901
(863) 676-8502
Mailing address
1154 ALLEGRO PL, DUNDEE, FL 33838-4042
(863) 651-5687
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA18037
FL
Other
Enumeration date
07/16/2021
Last updated
07/16/2021
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