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Individual

LANA CODALLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
5100 CRESTHAVEN BLVD, WEST PALM BEACH, FL 33415-8618
(561) 802-8539
Mailing address
2097 W BOND DR, WEST PALM BEACH, FL 33415-7027
(561) 802-8539

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA16671
FL

Other

Enumeration date
08/26/2019
Last updated
08/26/2019
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