Individual
MRS. KATHY MICHELLE VANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
895 POWERS BLVD, WAVERLY, TN 37185-1018
(931) 296-7552
Mailing address
103 OAK RIDGE DR, WAVERLY, TN 37185-1249
(931) 622-0417
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1923
TN
Other
Enumeration date
05/15/2013
Last updated
05/15/2013
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