Individual
KERRY ANN TEIXEIRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1219 DUNN AVE, DAYTONA BEACH, FL 32114-2405
(386) 255-4568
Mailing address
107 HENIN DR, DEBARY, FL 32713-5408
(407) 538-0537
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA17985
FL
Other
Enumeration date
02/18/2021
Last updated
02/18/2021
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