Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | ||
N | 225XL0004X | Low Vision | ||
Y | 225XP0200X | Occupational Therapist - Pediatrics |
NPI | 1194979682 |
---|---|
Provider Name | Tanya Tuckman |
First Address | Jacksonville, FL 32223-3218 |
Second Address | Jacksonville, FL 32223-3218 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/11/2008 |
Last Update Date | 10/11/2008 |