Individual
MRS. TYNISHA DOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1150 PONCE DE LEON BLVD, CLEARWATER, FL 33756-1041
(727) 585-5491
Mailing address
2681 ROOSEVELT BLVD, APT 4305, CLEARWATER, FL 33760-2962
(207) 610-0344
Taxonomy
Speciality
Code
Description
License number
State
225XG0600X
Gerontology Occupational Therapist
Primary
15805
FL
Other
Enumeration date
08/09/2016
Last updated
08/09/2016
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