Individual
TAKEISHA CHRISTA ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
4467 E MALLORY AVE, MEMPHIS, TN 38117-6939
(901) 428-5266
Mailing address
4467 E MALLORY AVE, MEMPHIS, TN 38117-6939
(901) 428-5266
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3156
TN
Other
Enumeration date
05/13/2019
Last updated
05/13/2019
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