Chastity Jolene Wooten

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

NPI 1407128358 · NPPES record last updated Nov 14, 2023

Key facts

NPI
1407128358
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
0000003856 (TN)
Practice address
700 Old Alabama Rd SW
MC Donald, TN 37353-5855
Phone
(276) 202-8138
NPI assigned
Feb 7, 2012
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
0000003856TNMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 0000003856 TN Yes

Addresses

Primary practice location

700 Old Alabama Rd SW
MC Donald, TN 37353-5855

Mailing address

700 Old Alabama Rd SW
MC Donald, TN 37353-5855
Phone (276) 202-8138

Other providers in MC Donald, TN

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

Sources for this page

Verify at the official NPI Registry.