Mary Beth Wylie, COTA
Individual provider Active NPI Occupational Therapy Assistant · Adamsville, TN
NPI 1295954683 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1295954683
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- License
- 1254 (TN)
- Practice address
- 409 Park Ave
Adamsville, TN 38310-2461 - Phone
- (731) 632-3301
- NPI assigned
- Apr 24, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 1254 | TN | Yes |
Addresses
Primary practice location
409 Park Ave
Adamsville, TN 38310-2461
Mailing address
1405 Downing Hollow Rd
Waynesboro, TN 38485-3846
Phone (931) 722-2832
Other providers in Adamsville, TN
- Tri-County Convalescent Home
- John W Vinson
- Katherine Kelly Vinson
- Katelyn Watkins
- Jessica Leann Woods
All providers in Adamsville, TN · Occupational Therapy Assistant in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.