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Contact Information

PHAEDRA TRITON, COTA
2103 GILMORE STREET
JACKSONVILLE, FL32204
 Phone: 904-906-3878
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Occupational Therapy Assistant

224Z00000X
Indicates primary specialty

NPI Profile & details for PHAEDRA TRITON · (Female)

NPI # 1164244810
Status Active
Credentials COTA (Certified Occupational Therapy Assistant)
Entity Individual
Enumeration date 10/24/2024
Last updated 10/28/2024 - More than a year ago
Sole proprietor 1 Yes
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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