Provider Demographics
NPI:1588394738
Name:ALMEIDA HUBLER, TANNIA (COTA)
Entity type:Individual
Prefix:
First Name:TANNIA
Middle Name:
Last Name:ALMEIDA HUBLER
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 W KINDERTON WAY APT 210
Mailing Address - Street 2:
Mailing Address - City:BERMUDA RUN
Mailing Address - State:NC
Mailing Address - Zip Code:27006-7385
Mailing Address - Country:US
Mailing Address - Phone:281-906-7878
Mailing Address - Fax:
Practice Address - Street 1:1351 SUSANNA WESLEY DR
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27104-1159
Practice Address - Country:US
Practice Address - Phone:866-658-2724
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-11
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14812224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant