Basic Information
| Provider Information | |||||||||
| NPI: | 1528111796 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | DIDIO | ||||||||
| FirstName: | FARRAH | ||||||||
| MiddleName: | FERRETTI | ||||||||
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| Credential: | OTA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5079 CANAL CIR E | ||||||||
| Address2: | |||||||||
| City: | LAKE WORTH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334671840 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5613894114 | ||||||||
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| Practice Location | |||||||||
| Address1: | 11381 PROSPERITY FARMS RD | ||||||||
| Address2: | |||||||||
| City: | PALM BEACH GARDENS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334103403 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5616949709 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/19/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 224Z00000X | OTA9366 | FL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant |
No ID Information.