Individual
TAMRA GAYLE SHORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
20300 LEONARD RD LOT 16, LUTZ, FL 33558-5301
(918) 853-5616
Mailing address
20300 LEONARD RD LOT 16, LUTZ, FL 33558-5301
(918) 853-5616
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA18755
FL
Other
Enumeration date
01/27/2022
Last updated
01/27/2022
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