Organization
HOMEGROWN THERAPY SWFL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANIELLE CRAIG (OCCUPATIONAL THERAPIST)
(239) 292-1832
Entity
Organization
Contact information
Practice address
2328 HANCOCK BRIDGE PKWY, CAPE CORAL, FL 33990-1459
(239) 478-7059
Mailing address
12440 EAGLE PERCH LN, CAPE CORAL, FL 33909-3047
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
013314100
—
FL
Enumeration date
09/21/2021
Last updated
01/23/2024
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