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Individual

MRS. CRYSTAL ELIZABETH TANGORRA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
9171 TANWOOD CIR, PHOENIX, NY 13135-3050
(315) 934-4046
Mailing address
9171 TANWOOD CIR, PHOENIX, NY 13135-3050
(315) 934-4046

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
007337-1
NY

Other

Enumeration date
12/09/2008
Last updated
12/09/2008
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