Individual
ANDREA KAY PUCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
610 E BELLA VISTA ST, LAKELAND, FL 33805-3008
(863) 688-8591
Mailing address
6300 COUNTY ROAD 561, CLERMONT, FL 34714-9171
(352) 638-7679
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
17505
FL
Other
Enumeration date
07/14/2021
Last updated
07/14/2021
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