Individual
MS. DIANE ELIZABETH TULLOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3759 CARAMBOLA CIR N, COCONUT CREEK, FL 33066-2443
(407) 921-9888
Mailing address
3759 CARAMBOLA CIR N, COCONUT CREEK, FL 33066-2443
(407) 921-9888
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
SW6624
FL
Other
Enumeration date
08/01/2011
Last updated
08/01/2011
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