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Individual

MR. ERYAN RYDELL SINGALAWA HERNANDEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
COTA

Contact information

Practice address
6733 QUINCE RD, MEMPHIS, TN 38119-8602
(901) 755-3860
Mailing address
2791 COLONIAL TOWERS DR, CORDOVA, TN 38016-4635
(901) 426-9612

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3663
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3663
BOARD OF OT LICENSE NUMBER
TN
Enumeration date
08/01/2022
Last updated
08/01/2022
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