Individual
MRS. MICHELE LEE TISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L, CLT-LANA
Contact information
Practice address
1104 W HIAWATHA ST, TAMPA, FL 33604-6413
(813) 743-1390
Mailing address
1104 W HIAWATHA ST, TAMPA, FL 33604-6413
(813) 743-1390
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA8904
FL
Other
Enumeration date
06/10/2024
Last updated
06/10/2024
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