Individual
TANGE MARIE WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
925 S SEMRN BLVD, 110A, WINTER PARK, FL 32792-5313
(888) 830-1050
Mailing address
12301 KERNAN FOREST BLVD, 2302, JACKSONVILLE, FL 32225-5597
(904) 894-8646
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
13422
FL
Other
Enumeration date
07/27/2015
Last updated
07/27/2015
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