Individual
MELISSA JERVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
2955 SW 22ND ST, CORAL GABLES, FL 33145-3205
(954) 356-2878
Mailing address
13812 SW 275TH ST, HOMESTEAD, FL 33032-3204
(786) 536-0015
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
OTA13912
FL
Other
Enumeration date
07/20/2016
Last updated
07/20/2016
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