Emma Ingram

Individual provider Active NPI Occupational Therapy Assistant · Bradyville, TN

NPI 1700599347 · NPPES record last updated Dec 28, 2022

Key facts

NPI
1700599347
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
3815 (TN)
Practice address
830 Parker Dr
Bradyville, TN 37026-5020
Phone
(931) 247-8532
NPI assigned
Dec 28, 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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 3815 TN Yes

Addresses

Primary practice location

830 Parker Dr
Bradyville, TN 37026-5020

Mailing address

830 Parker Dr
Bradyville, TN 37026-5020

Other providers in Bradyville, TN

All providers in Bradyville, TN · Occupational Therapy Assistant in Tennessee

Sources for this page

Verify at the official NPI Registry.