| NPI | 1073654539 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL E TIETZ Owner 727-809-3326 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics (Licence: FL OT1010) |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2019-02-06 |