Individual
CARLENA LONGMIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
4411 N HABANA AVE, TAMPA, FL 33614-7211
(727) 455-3751
Mailing address
8806 TORCHWOOD DR, TRINITY, FL 34655-5333
(727) 455-3751
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA17727
FL
Other
Enumeration date
04/14/2020
Last updated
04/14/2020
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