Carson Elise Bailey, COTA/L

Individual provider Active NPI Occupational Therapy Assistant · MC Kenzie, TN

NPI 1386375400 · NPPES record last updated Jun 20, 2022

Key facts

NPI
1386375400
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
3826 (TN)
Practice address
14510 Highway 79
MC Kenzie, TN 38201-7824
Phone
(731) 352-5317
Fax
(731) 352-5942
NPI assigned
Jun 20, 2022
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
3826TNMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 3826 TN Yes

Addresses

Primary practice location

14510 Highway 79
MC Kenzie, TN 38201-7824

Mailing address

224 High St
Huntingdon, TN 38344-3206
Phone (731) 499-0295

Other names

  • Carson Elise Hatch Former name

Other providers in MC Kenzie, TN

All providers in MC Kenzie, TN · Occupational Therapy Assistant in Tennessee

Sources for this page

Verify at the official NPI Registry.