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General NPI Number Information
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NPI Number | 1508124710
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Entity Type | Individual
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Provider Name | ELLEN GRACE HUNTER OTR/L
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Gender | Female
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Dates
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Enumeration Date | 04/25/2012
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Last Update Date | 02/20/2014
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Provider Practice Location Address
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Address Line | 600 N WEST SHORE BLVD SUITE 601
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City | TAMPA
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State | FL
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Zip | 33609-1140
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Country | US
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Telephone | 813-371-3423
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 51736
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City | SARASOTA
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State | FL
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Zip | 34232-0334
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Country | US
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Telephone | 440-263-2040
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 06888
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License Number State | MD
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