Individual
TAWANA CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
926 BLACK CORAL AVE NW, PALM BAY, FL 32907-9493
(321) 750-6809
Mailing address
926 BLACK CORAL AVE NW, PALM BAY, FL 32907-9493
(321) 750-6809
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
10729
FL
225X00000X
Occupational Therapist
OC60632347
WA
Other
Enumeration date
03/31/2016
Last updated
03/31/2016
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