Individual
MISS TIFFANY MARIE KANZLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
805 N WALNUT ST, UNIT 2B, ITASCA, IL 60143-2884
(386) 214-7525
Mailing address
805 N WALNUT ST, UNIT 2 B, ITASCA, IL 60143-2884
(386) 214-7525
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057003617
IL
224Z00000X
Occupational Therapy Assistant
OTA11852
FL
Other
Enumeration date
04/23/2012
Last updated
09/13/2012
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