Individual
MIRIAM KORAISHA TAHIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.O.T.A
Contact information
Practice address
4242 LAKELAND HIGHLANDS RD, LAKELAND, LAKELAND, FL 33813-2816
(863) 607-5948
Mailing address
2224 EDEN PKWY, LAKELAND, LAKELAND, FL 33803-2816
(863) 687-0668
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA 10204
FL
Other
Enumeration date
05/21/2007
Last updated
07/08/2007
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