Individual
TYRA YOUNGBLOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
401 E SAMPLE RD, DEERFIELD BEACH, FL 33064-4441
(561) 715-3193
Mailing address
11282 MILLPOND GREENS DR, BOYNTON BEACH, FL 33473-7800
(561) 715-3193
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA17975
FL
Other
Enumeration date
01/06/2021
Last updated
01/06/2021
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