Individual
SERAH ROSE TIDEI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
90 HOWARD DR, SHELBYVILLE, KY 40065-8138
(502) 523-8849
Mailing address
90 HOWARD DR, SHELBYVILLE, KY 40065-8138
(502) 523-8849
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
286937
KY
225X00000X
Occupational Therapist
31007099A
IN
Other
Enumeration date
03/27/2017
Last updated
02/01/2024
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