Provider Demographics
NPI:1275889016
Name:NASSEF, TINA MARIE (COTA/L)
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:MARIE
Last Name:NASSEF
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2223 LOCKSLEY WOODS DR APT E
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-5455
Mailing Address - Country:US
Mailing Address - Phone:253-342-1699
Mailing Address - Fax:
Practice Address - Street 1:2223 LOCKSLEY WOODS DR APT E
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-5455
Practice Address - Country:US
Practice Address - Phone:253-342-1699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-31
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0131001007224Z00000X
NC7109224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant