Individual
THERESA FITZGERALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
5405 BABCOCK ST NE, PALM BAY, FL 32905-5020
(321) 722-0660
Mailing address
5405 BABCOCK ST NE, PALM BAY, FL 32905-5020
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA 10285
FL
Other
Enumeration date
06/08/2013
Last updated
06/08/2013
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