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Individual

MS. TINA A. WILLS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
COTA

Contact information

Practice address
347 MYRTLEWOOD RD, MELBOURNE, FL 32940-7768
(321) 626-4970
Mailing address
347 MYRTLEWOOD RD, MELBOURNE, FL 32940-7768
(321) 626-4970

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA 15363
FL

Other

Enumeration date
01/11/2017
Last updated
04/02/2024
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