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General NPI Number Information
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NPI Number | 1649641036
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Entity Type | Individual
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Provider Name | YUEN TING CHAN M.S., OTR/L
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Gender | Female
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Dates
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Enumeration Date | 10/12/2015
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Last Update Date | 01/27/2016
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Provider Practice Location Address
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Address Line | 12080 SW HIGHWAY 484
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City | DUNNELLON
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State | FL
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Zip | 34432-6408
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Country | US
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Telephone | 352-489-4001
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Fax |
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Provider Business Mailing Address
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Address Line | 5001 SW 20TH ST APT 3516
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City | OCALA
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State | FL
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Zip | 34474-8571
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Country | US
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Telephone | 407-990-0338
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT16548
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License Number State | FL
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