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Individual

TARA MADEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
VETERANS WAY & LAMONT ST, MOUNTAIN HOME, TN 37684
(423) 926-1171
Mailing address
2324 ANCIENT OAK LN, KNOXVILLE, TN 37931-4186

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4709
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1053712208
NPI
Enumeration date
09/08/2014
Last updated
09/08/2014
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