Individual
MARY DAVIDSON HERROLD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTA
Contact information
Practice address
312 ANDOVER DR, SMYRNA, TN 37167-5143
(615) 355-6767
(615) 231-5072
Mailing address
312 ANDOVER DR, SMYRNA, TN 37167-5143
(615) 355-6767
(615) 231-5072
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
546
TN
Other
Enumeration date
09/06/2011
Last updated
09/19/2011
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