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General NPI Number Information
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NPI Number | 1750736393
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Entity Type | Individual
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Provider Name | RYANN COSTA
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Gender | Female
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Dates
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Enumeration Date | 05/02/2016
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Last Update Date | 05/02/2016
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Provider Practice Location Address
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Address Line | 1192 SE 3RD TER
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City | DEERFIELD BEACH
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State | FL
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Zip | 33441-6810
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Country | US
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Telephone | 551-206-5863
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Fax |
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Provider Business Mailing Address
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Address Line | 1192 SE 3RD TER
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City | DEERFIELD BEACH
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State | FL
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Zip | 33441-6810
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Country | US
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Telephone |
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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 | 17133
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 15251
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 1432
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License Number State | HI
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Taxonomy #4
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 46TR00670200
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License Number State | NJ
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