Provider Demographics
NPI:1497224752
Name:TOOMER WATSON, DANESHIA S
Entity Type:Individual
Prefix:
First Name:DANESHIA
Middle Name:S
Last Name:TOOMER WATSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 CENTER STONE LN
Mailing Address - Street 2:
Mailing Address - City:RIVIERA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33404-1826
Mailing Address - Country:US
Mailing Address - Phone:954-701-3397
Mailing Address - Fax:
Practice Address - Street 1:1100 CENTER STONE LN
Practice Address - Street 2:
Practice Address - City:RIVIERA BEACH
Practice Address - State:FL
Practice Address - Zip Code:33404-1826
Practice Address - Country:US
Practice Address - Phone:954-701-3397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-16
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT17369225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist