Individual
KATHRYN TANCIG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSW/ITDS
Contact information
Practice address
12515 153RD CT N, JUPITER, FL 33478-6600
(561) 308-9418
Mailing address
12515 153RD CT N, JUPITER, FL 33478-6600
(561) 308-9418
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
222Q00000X
—
FL
Enumeration date
06/20/2008
Last updated
06/20/2008
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