Individual
TANISHA DRAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1919 W MAIN ST, ALBEMARLE, NC 28001-5419
(917) 966-0722
Mailing address
364 W 117TH ST APT 5C, NEW YORK, NY 10026-1563
(917) 966-0722
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
023437
NY
225X00000X
Occupational Therapist
Primary
13900
NC
Other
Enumeration date
04/20/2021
Last updated
04/20/2021
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