Individual
MRS. DEBORAH HICKERNELL GRISNIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T.R.
Contact information
Practice address
910 N JEFFERSON ST, JACKSONVILLE, FL 32209-6810
(904) 360-7022
(904) 798-4544
Mailing address
910 N JEFFERSON ST, JACKSONVILLE, FL 32209-6810
(904) 360-7022
(904) 798-4544
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
—
—
225X00000X
Occupational Therapist
Primary
OT 1342
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
811876100
—
FL
05
—
881767700
—
FL
Enumeration date
01/08/2007
Last updated
04/28/2008
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