Individual
DIANA WHITAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
804 SHANNONDALE WAY, MARYVILLE, TN 37803-5970
(865) 982-4599
Mailing address
535 DOC NORTON RD, WALLAND, TN 37886-2006
(865) 414-2051
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1723
TN
Other
Enumeration date
04/23/2024
Last updated
04/23/2024
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