Marcia Ann Krokowski, COTA

Individual provider Active NPI Occupational Therapy Assistant · Humboldt, TN

NPI 1376651430 · NPPES record last updated Nov 28, 2011

Key facts

NPI
1376651430
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
1719 (TN)
Practice address
2400 E Mitchell St
Humboldt, TN 38343-3036
Phone
(731) 784-5183
Fax
(731) 784-2105
NPI assigned
Aug 29, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1719TNMDAthletic Trainer

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 1719 TN Yes

Addresses

Primary practice location

2400 E Mitchell St
Humboldt, TN 38343-3036

Mailing address

2400 E Mitchell St
Humboldt, TN 38343-3036
Phone (731) 784-5183

Other providers in Humboldt, TN

All providers in Humboldt, TN · Occupational Therapy Assistant in Tennessee

Sources for this page

Verify at the official NPI Registry.