Individual
MRS. ANGELA WILLOUGHBY TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
447 NW 73RD AVE, PLANTATION, FL 33317-1608
(954) 583-7383
(954) 583-7388
Mailing address
447 NW 73RD AVE, PLANTATION, FL 33317-1608
(954) 583-7383
(954) 583-7388
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA 10754
FL
Other
Enumeration date
04/21/2009
Last updated
04/21/2009
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