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Individual

MELISSA BLAIR GARDNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
3960 NEW COVINGTON PIKE, MEMPHIS, TN 38128-2504
(901) 516-5320
Mailing address
3960 NEW COVINGTON PIKE, MEMPHIS, TN 38128-2504
(901) 516-5320

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2374
TN
224Z00000X
Occupational Therapy Assistant
A02386
MD

Other

Enumeration date
09/13/2016
Last updated
04/28/2020
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