Individual
ANDRA MICHELLE HUBBARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1653 MOORESVILLE HWY, LEWISBURG, TN 37091-2005
(931) 359-4506
Mailing address
1653 MOORESVILLE HWY, LEWISBURG, TN 37091-2005
(931) 359-4506
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA0000001963
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
TN3787
SNF
—
Enumeration date
10/05/2016
Last updated
10/05/2016
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