Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT20736 | FL |
NPI | 1003442807 |
---|---|
Provider Name | Mrs. Lauren Cheryl Sheridan |
First Address | Tampa, FL 33611-3273 |
Second Address | Tampa, FL 33617-5310 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/03/2020 |
Last Update Date | 12/08/2020 |