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NPI Code Detail

MEDICARE: TABITHA MCMANUS

MEDICARE: TABITHA MCMANUS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational TherapistOT17319CA

General Provider Information

NPI Number : 1346779725
Entity Type Code : Individual
Provider Name (Legal Business Name) : TABITHA MCMANUS
Provider Business Mailing Address
First Line : 6333 CANOGA AVE APT 163
Second Line :
City : WOODLAND HILLS
State : CA
Zip : 91367-7710
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 28212 KELLY JOHNSON PKWY STE 200
Second Line :
City : VALENCIA
State : CA
Zip : 91355-5090
Country : US
Telephone Number : 954-609-7971
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2017
Last Update Date : 06/08/2017

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Directions to “ TABITHA MCMANUS ” Practice Location

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