Individual
MISS JAYNEE MARIE NIELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
5509 W GRAY ST, TAMPA, FL 33609-1053
(187) 736-0782
Mailing address
5509 W GRAY ST, TAMPA, FL 33609-1053
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
01195
IA
225X00000X
Occupational Therapist
12531
FL
Other
Enumeration date
01/24/2012
Last updated
10/29/2012
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