Individual
MRS. JANE ANN TIEDEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
27313 DOMINICA LN, RAMROD KEY, FL 33042-5453
(305) 923-3820
Mailing address
27313 DOMINICA LN, RAMROD KEY, FL 33042-5453
(305) 923-3820
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT 10529
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
887682700
—
FL
Enumeration date
10/25/2006
Last updated
03/19/2010
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