Individual
JENNIFER LYNN MATTHIESEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
4555 S MANHATTAN AVE, TAMPA, FL 33611-2305
(708) 466-2442
Mailing address
4555 S MANHATTAN AVE, TAMPA, FL 33611-2305
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA10783
FL
Other
Enumeration date
05/06/2010
Last updated
05/06/2010
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