Tracey G Anderson
Individual provider Active NPI Occupational Therapist · Heritage, TN
NPI 1912460965 · NPPES record last updated Apr 8, 2019
Key facts
- NPI
- 1912460965
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- OT36200 (TN)
- Practice address
- 3515 Central Pike
Suite 104
Heritage, TN 37066 - Phone
- (800) 381-2195
- Fax
- (888) 381-0822
- NPI assigned
- Apr 8, 2019
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
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 |
|---|---|---|---|
| OT36200 | TN | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Let'S Talk Therapy, LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT36200 | TN | Yes |
Addresses
Primary practice location
3515 Central Pike
Suite 104
Heritage, TN 37066
Mailing address
4500 Satellite Blvd Ste 2250
Duluth, GA 30096-5047
Phone (800) 381-2195
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 8, 2019. 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.