Provider Demographics
NPI:1235390279
Name:GRANTHAM, MARIA R SESSA (OTR/L, MS)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:R SESSA
Last Name:GRANTHAM
Suffix:
Gender:F
Credentials:OTR/L, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1428 32ND AVE N
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33704-1947
Mailing Address - Country:US
Mailing Address - Phone:727-510-9840
Mailing Address - Fax:
Practice Address - Street 1:1428 32ND AVE N
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33704-1947
Practice Address - Country:US
Practice Address - Phone:727-510-9840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-23
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT10076225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist