Individual
MRS. GLORIA IVELISSE MORALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTA
Contact information
Practice address
255 E. MAIN ST, LAKE ALFRED, FL 33850
(863) 956-0411
Mailing address
255 E MAIN ST, LAKE ALFRED, FL 33850-2133
(863) 956-0411
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTA9643
FL
Other
Enumeration date
10/20/2016
Last updated
10/20/2016
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