Individual
MRS. TARA CUNNINGHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MOT, OTR/L, ATP
Contact information
Practice address
2420 HOFFNER AVE, BELLE ISLE, FL 32809-3538
(386) 679-5450
Mailing address
2420 HOFFNER AVE, BELLE ISLE, FL 32809-3538
(386) 679-5450
Taxonomy
Speciality
Code
Description
License number
State
225XN1300X
Neurorehabilitation Occupational Therapist
Primary
OT12269
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT12269
OT LICENSE NUMBER
FL
Enumeration date
09/14/2017
Last updated
07/21/2022
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