Individual
JANNA FAY KNICKERBOCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
3960 NEW COVINGTON PIKE, MEMPHIS, TN 38128-2504
(901) 516-5320
(901) 516-5099
Mailing address
3960 NEW COVINGTON PIKE, MEMPHIS, TN 38128-2504
(901) 516-5320
(901) 516-5099
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0531
TN
Other
Enumeration date
04/24/2020
Last updated
04/24/2020
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