Provider Demographics
NPI:1912453853
Name:WRASSMANN, EMMA LEE (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:EMMA
Middle Name:LEE
Last Name:WRASSMANN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2150 ALT 19 STE A
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34683-5363
Mailing Address - Country:US
Mailing Address - Phone:727-773-2687
Mailing Address - Fax:
Practice Address - Street 1:2150 ALT 19 STE A
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34683-5363
Practice Address - Country:US
Practice Address - Phone:727-773-2687
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-31
Last Update Date:2019-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT18003225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL018662800Medicaid