Individual
MRS. TARA LYNN OPACZEWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
17495 DUGDALE DR, SOUTH BEND, IN 46635-1545
(574) 247-7500
Mailing address
17495 DUGDALE DR, SOUTH BEND, IN 46635-1545
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
01/31/2019
Last updated
01/31/2019
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