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Individual

MRS. NANCY NANETTE TIENHAARA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S, ATC L, EMT

Contact information

Practice address
4850 W OAKLAND PARK BLVD, LAUDERDALE LAKES, FL 33313-7268
(954) 731-7440
(954) 731-7675
Mailing address
9340 NW 33RD PL, SUNRISE, FL 33351-7123
(954) 747-8680

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
AL1661
FL

Other

Enumeration date
06/07/2006
Last updated
07/08/2007
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