Individual
MS. TINA M JANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
5784 HAZEL DR, FLORENCE, KY 41042-1220
(859) 743-5204
Mailing address
5784 HAZEL DR, FLORENCE, KY 41042-1220
(859) 743-5204
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
KYA3127
KY
224Z00000X
Occupational Therapy Assistant
OTA-03129
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03129
COTA/L
OH
01
—
KYA3127
COTA/L
KY
Enumeration date
07/24/2012
Last updated
07/24/2012
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