Individual
MS. NOLA JEAN RAYSON-LOCKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
152 TIGERLILY COURT, SUITE 109, DAVENPORT, FL 33836
(863) 430-6299
(863) 438-4345
Mailing address
PO BOX 2410, DAVENPORT, FL 33836-2410
(863) 430-6299
(863) 438-4345
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
OT0686
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT0686
OCCUPATIONAL THERAPIST
MS
Enumeration date
05/01/2007
Last updated
06/11/2010
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