Provider Demographics
NPI:1386956886
Name:CRISAFULLE HOWELL, TAMMY ANN (OTR/L, CHT)
Entity type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:ANN
Last Name:CRISAFULLE HOWELL
Suffix:
Gender:F
Credentials:OTR/L, CHT
Other - Prefix:MRS
Other - First Name:TAMMY
Other - Middle Name:ANN
Other - Last Name:HOWELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTR/L, CHT
Mailing Address - Street 1:12029 56TH PL N
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-8533
Mailing Address - Country:US
Mailing Address - Phone:561-255-7626
Mailing Address - Fax:
Practice Address - Street 1:12029 56TH PL N
Practice Address - Street 2:
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-8533
Practice Address - Country:US
Practice Address - Phone:561-255-7626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-13
Last Update Date:2010-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT4762225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist