Individual
MS. ROBERTA DIANE MCCLENDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
2400 E MITCHELL ST, HUMBOLDT, TN 38343-3036
(731) 784-5184
(731) 784-2105
Mailing address
45 PINEWOOD CV, JACKSON, TN 38305-9160
(731) 499-1318
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT0000001553
TN
Other
Enumeration date
02/03/2012
Last updated
02/03/2012
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