Organization
STATE OF TENNESSEE
Active
Other names
Tennessee Department of Intellectual and Developmental Disabilities
Organization subpart
No
Provider details
NPI number
Authorized official
ANDY KIDD (DEPUTY COMMISSIONER)
(615) 253-6710
Entity
Organization
Contact information
Practice address
301 STEWARTS FERRY PIKE, NASHVILLE, TN 37214-3340
(615) 231-5147
(615) 886-9972
Mailing address
315 DEADERICK ST FL 8, NASHVILLE, TN 37238-3000
(615) 532-6530
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q017827
—
TN
Enumeration date
06/08/2015
Last updated
06/05/2024
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