Individual
MINDRA ASHLEY PEREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
56 POST VIEW DR, PALM COAST, FL 32164-4948
(386) 270-2664
Mailing address
PO BOX 1088, BUNNELL, FL 32110-1088
(386) 270-2664
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA13611
FL
224ZE0001X
Environmental Modification Occupational Therapy Assistant
—
—
224ZF0002X
Feeding, Eating & Swallowing Occupational Therapy Assistant
OTA13611
FL
224ZL0004X
Low Vision Occupational Therapy Assistant
—
—
Other
Enumeration date
06/26/2018
Last updated
06/26/2018
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