Individual
TRACY LYNN ANGUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
7243 US HIGHWAY 301 S, RIVERVIEW, FL 33578-8399
(813) 663-9828
Mailing address
12208 LANGSHAW DR, THONOTOSASSA, FL 33592-2732
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT11118
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022100400
—
FL
Enumeration date
05/04/2007
Last updated
09/29/2017
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