Provider Demographics
NPI:1619068236
Name:HALLMAN, TANYA RENEE (OTR L)
Entity Type:Individual
Prefix:MISS
First Name:TANYA
Middle Name:RENEE
Last Name:HALLMAN
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 1:801 SE 16TH CT
Mailing Address - Street 2:UNIT #5
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33316-2982
Mailing Address - Country:US
Mailing Address - Phone:763-350-2129
Mailing Address - Fax:
Practice Address - Street 1:801 SE 16TH CT
Practice Address - Street 2:UNIT #5
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316-2982
Practice Address - Country:US
Practice Address - Phone:763-350-2129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2011-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT14421225X00000X
MN102813225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist