Provider Demographics
NPI:1043777261
Name:O'SHEA, TARAH ELIZABETH (OTR/L)
Entity Type:Individual
Prefix:
First Name:TARAH
Middle Name:ELIZABETH
Last Name:O'SHEA
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14312 HERRING HOLW
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609-0512
Mailing Address - Country:US
Mailing Address - Phone:585-662-9889
Mailing Address - Fax:
Practice Address - Street 1:246 MARINER BLVD
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34609-5691
Practice Address - Country:US
Practice Address - Phone:352-683-2102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-24
Last Update Date:2019-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT19540225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist