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Individual

TINA MARIE WEAVER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
1524 S EAST AVE, SARASOTA, FL 34239-2324
(941) 365-2422
Mailing address
904 WABASH RD, VENICE, FL 34293-6460
(941) 650-6036

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
16136
FL

Other

Enumeration date
03/21/2019
Last updated
03/21/2019
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