Individual
MRS. TANYA LEE LIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTD, OTRL
Contact information
Practice address
11753 FOWLER AVENUE, OMAHA, NE 68164
(402) 630-2874
Mailing address
11753 FOWLER AVE, OMAHA, NE 68164-2223
(402) 630-2874
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1230
NE
Other
Enumeration date
05/22/2007
Last updated
07/08/2007
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