Individual
JENNIFER ISHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
120 CAVETTE HILL LN, KNOXVILLE, TN 37934-6673
(865) 777-4000
Mailing address
225 SKYLINE VIEW LN, KINGSTON, TN 37763-7274
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA0000002557
TN
Other
Enumeration date
11/20/2015
Last updated
11/20/2015
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