Individual
CARRIE ELIZABETH FERGUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2565 JUDGE FRAN JAMIESON WAY, VIERA, FL 32940-5998
(321) 634-3688
(321) 504-0955
Mailing address
PO BOX 781577, ORLANDO, FL 32878-1577
(321) 961-3489
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
10/12/2016
Last updated
10/12/2016
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