Shanita Venise Tyson, COTA

NPI #1619485562 in Eustis, Florida

Provider Information

NPI Number: 1619485562
Entity Type: Individual
Name: Shanita Venise Tyson, COTA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Occupational Therapist
Credential: COTA
Enumeration Date: Jan 12, 2018
Last Updated: May 26, 2021

Practice Location

Address: 6 N EUSTIS ST
City: Eustis
State: Florida
ZIP Code: 32726-3408
Phone: (321) 276-5054

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapist	225X00000X	Primary

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