DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DETRA SHAUNTEL SIMPO, OTR/L

Active Sole Proprietor

DETRA SHAUNTEL SIMPO, OTR/L is a Occupational Therapist healthcare provider located in ST JOHNS, Florida. NPI 1710071220 is currently active in the NPPES registry. Verify at CMS.

Occupational Therapist · ST JOHNS, FL

Registration Details

NPI Number
1710071220
Provider Type
Individual
Gender
Female
NPI Issued
Oct 2, 2006 (19.859426781371 yrs)
Last Updated
Sep 1, 2020
License
OT9940 (FL)
Sole Proprietor
Yes

Practice Information

Address
518 DRY BRANCH WAY
ST JOHNS, FL, 322596203
Browse FL providers · Browse ZIP 32259
Phone
9043827886
Primary Specialty
Occupational Therapist
225X00000X

Other Occupational Therapist Providers in ST JOHNS, FL

Name Credential NPI
ELIZABETH LONGENDELPHER OT 1760231336
ALELEE HERRERA OTR/L 1629895982
ZIVANA HOFFSTETTER 1437948668
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.