Marilyn Burgess, COTA/L

Individual provider Active NPI Occupational Therapist · Dickson, TN

NPI 1508201716 · NPPES record last updated May 1, 2013

Key facts

NPI
1508201716
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
OTA0000001179 (TN)
Practice address
115 Academy St
Dickson, TN 37055-2013
Phone
(615) 446-2085
Fax
(615) 441-4132
NPI assigned
May 1, 2013
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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
OTA0000001179TNMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dickson County Schools Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OTA0000001179 TN Yes

Addresses

Primary practice location

115 Academy St
Dickson, TN 37055-2013

Mailing address

111 Robert Porter Rd
Dickson, TN 37055-3318
Phone (615) 740-1080

Other providers in Dickson, TN

All providers in Dickson, TN · Occupational Therapist in Tennessee

Sources for this page

Verify at the official NPI Registry.