Detra Shauntel Simpo, OTR/L
Occupational Therapist in St Johns, FL. Individual provider (NPI-1).
NPI number1710071220
StatusActive
Last updated in NPPESSep 1, 2020
Details
- NPI
- 1710071220
- Entity type
- Individual (NPI-1)
- Name
- Detra Shauntel Simpo
- Credential
- OTR/L
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Oct 2, 2006
- Certification date
- Sep 1, 2020
- Last updated
- Sep 1, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225X00000X | Occupational Therapist | OT9940 | FL | Yes |
Practice location
518 Dry Branch WaySt Johns, FL 32259-6203
Phone 904-382-7886
Mailing address
518 Dry Branch WaySt Johns, FL 32259-6203
Phone 904-382-7886
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Other Occupational Therapist providers in St Johns, FL
- Alelee Herrera, OTR/LNPI 1629895982
- Zivana HoffstetterNPI 1437948668
- Elizabeth Longendelpher, OTNPI 1760231336
- Therapedz Therapist Unlimited, LLCNPI 1952074007
All 5 Occupational Therapist providers in St Johns · All 309 providers in St Johns
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