Jason Gonzalez, COTA/L
Individual provider Active NPI Occupational Therapy Assistant · Pleasant Hill, TN
NPI 1417429481 · NPPES record last updated Dec 31, 2018
Key facts
- NPI
- 1417429481
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- License
- 2724 (TN)
- Practice address
- 55 W Lake Rd
Pleasant Hill, TN 38578-3002 - Phone
- (931) 250-3050
- NPI assigned
- Dec 31, 2018
- Sex
- Male
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 2724 | TN | MD | Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant |
224Z00000X | 2724 | TN | Yes |
Addresses
Primary practice location
55 W Lake Rd
Pleasant Hill, TN 38578-3002
Mailing address
4727 Creston Rd
Crossville, TN 38571-0625
Phone (931) 250-3080
Other providers in Pleasant Hill, TN
- Zelda Cheesman Croteau
- Melissa Mary Dalton
- Matthew Thane Davis
- Sonia L Finch
- Amanda Fuentes
- Karissa Breanne Green
- Janel L Hostetler
- Timothy Dwain Houston
- Benjamin Jordan
- Emalea Keyes
All providers in Pleasant Hill, 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 Dec 31, 2018. 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.