Selene W Dismukes, COTA L
Individual provider Active NPI Occupational Therapy Assistant · Lawerenceburg, TN
NPI 1982767356 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1982767356
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- License
- OTA951 (TN)
- Practice address
- NHC Scott
Buffalo Rd
Lawerenceburg, TN 38464 - Phone
- (931) 762-9418
- Fax
- (931) 766-0573
- NPI assigned
- Dec 18, 2006
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OTA951 | TN | MD | Occupational Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | OTA951 | TN | Yes |
Addresses
Primary practice location
NHC Scott
Buffalo Rd
Lawerenceburg, TN 38464
Mailing address
73 Lodi Rd
Westpoint, TN 38486
Phone (931) 766-0287
Other providers in Lawerenceburg, TN
All providers in Lawerenceburg, 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 Jul 8, 2007. 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.