Provider Demographics
NPI:1811419120
Name:NASCENE, TAMARA ROSEANNE (OTR/L)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:ROSEANNE
Last Name:NASCENE
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 1:1886 GRANT RD
Mailing Address - Street 2:
Mailing Address - City:ARDEN HILLS
Mailing Address - State:MN
Mailing Address - Zip Code:55112-7805
Mailing Address - Country:US
Mailing Address - Phone:651-303-4368
Mailing Address - Fax:
Practice Address - Street 1:1886 GRANT RD
Practice Address - Street 2:
Practice Address - City:ARDEN HILLS
Practice Address - State:MN
Practice Address - Zip Code:55112-7805
Practice Address - Country:US
Practice Address - Phone:651-303-4368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-10
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation