Provider Demographics
NPI:1417371667
Name:TINGEN, ALANA (MS, OTR/L)
Entity Type:Individual
Prefix:MISS
First Name:ALANA
Middle Name:
Last Name:TINGEN
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1460 9TH PL APT 253
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-2122
Mailing Address - Country:US
Mailing Address - Phone:919-637-5861
Mailing Address - Fax:
Practice Address - Street 1:1460 9TH PL APT 253
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-2122
Practice Address - Country:US
Practice Address - Phone:919-637-5861
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-08
Last Update Date:2020-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9064225X00000X
FL17507225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL783845Medicaid