Detra Shauntel Simpo, OTR/L

NPI #1710071220 in St Johns, Florida

Provider Information

NPI Number: 1710071220
Entity Type: Individual
Name: Detra Shauntel Simpo, OTR/L
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Occupational Therapist
Credential: OTR/L
Enumeration Date: Oct 2, 2006
Last Updated: Sep 1, 2020

Practice Location

Address: 518 DRY BRANCH WAY
City: St Johns
State: Florida
ZIP Code: 32259-6203
Phone: (904) 382-7886

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapist	225X00000X	Primary

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