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Individual

MRS. MAKENSIE RAE DUDLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
3180 PROFESSIONAL PLZ STE 101, GERMANTOWN, TN 38138-1534
(901) 328-2110
Mailing address
7830 GROVE BROOK CT UNIT 14-101, GERMANTOWN, TN 38138-3305
(731) 441-3575

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
6597
TN

Other

Enumeration date
08/24/2020
Last updated
08/24/2020
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