Provider Demographics
NPI:1588977235
Name:RICHARDS, JOAN GARGIULA (OT)
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:GARGIULA
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:JOAN
Other - Middle Name:
Other - Last Name:GARGIULA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12610 PANASOFFKEE DR
Mailing Address - Street 2:
Mailing Address - City:NORTH FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33903-4748
Mailing Address - Country:US
Mailing Address - Phone:239-217-0183
Mailing Address - Fax:
Practice Address - Street 1:9250 CORKSCREW RD
Practice Address - Street 2:UNIT 10
Practice Address - City:ESTERO
Practice Address - State:FL
Practice Address - Zip Code:33928-3208
Practice Address - Country:US
Practice Address - Phone:239-390-1656
Practice Address - Fax:239-390-1686
Is Sole Proprietor?:No
Enumeration Date:2010-07-23
Last Update Date:2010-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT3450225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist