Individual
LEAH MORTENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1136 PENMAN RD, JACKSONVILLE BEACH, FL 32250-3668
(904) 566-1287
Mailing address
7701 TIMBERLIN PARK BLVD APT 432, JACKSONVILLE, FL 32256-5441
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
19364
FL
Other
Enumeration date
03/23/2023
Last updated
03/23/2023
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