Individual
KIMBERLY NICOLE TANISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
200 PAULINE DR, YORK, PA 17402-4625
(717) 741-0824
Mailing address
455A BUTTONWOOD LN, YORK, PA 17406-9060
(814) 659-8809
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC011101
PA
Other
Enumeration date
03/29/2010
Last updated
03/29/2010
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