Provider Demographics
NPI:1770660466
Name:TANNREUTHER, DIANNE HILL (MS, OTR)
Entity Type:Individual
Prefix:MS
First Name:DIANNE
Middle Name:HILL
Last Name:TANNREUTHER
Suffix:
Gender:F
Credentials:MS, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12501 HYMEADOW DR
Mailing Address - Street 2:SUITE F
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78750-2263
Mailing Address - Country:US
Mailing Address - Phone:512-331-5488
Mailing Address - Fax:512-331-5489
Practice Address - Street 1:12501 HYMEADOW DR
Practice Address - Street 2:SUITE F
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-2263
Practice Address - Country:US
Practice Address - Phone:512-331-5488
Practice Address - Fax:512-331-5489
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101591225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXCCP105640Medicaid