Betty Jean Wells, OTR

Individual provider Active NPI Intellectual and/or Developmental Disabilities Residential Treatment Facility · Mosheim, TN

NPI 1376752154 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1376752154
Entity type
Individual (NPI type 1)
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X
License
1972 (TN)
Practice address
7040 Blue Springs Pkwy
C-13
Mosheim, TN 37818-3767
Phone
(423) 422-7137
NPI assigned
May 21, 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

State licenses

LicenseStateTypeSpecialty
1972TNMDRegistered Dietitian

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X 1972 TN Yes

Addresses

Primary practice location

7040 Blue Springs Pkwy
C-13
Mosheim, TN 37818-3767

Mailing address

7040 Blue Springs Pkwy
C-13
Mosheim, TN 37818-3767
Phone (423) 422-7137

Other providers in Mosheim, TN

All providers in Mosheim, TN · Intellectual and/or Developmental Disabilities Residential Treatment Facility in Tennessee

Sources for this page

Verify at the official NPI Registry.