Individual
MS. JOAN CHARLENE DEWEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1382 MARVIN RD, BOLIVAR, TN 38008-1720
(731) 659-3104
Mailing address
1382 MARVIN RD, BOLIVAR, TN 38008-1720
(731) 659-3104
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0000000045
TN
Other
Enumeration date
07/15/2008
Last updated
07/15/2008
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