Individual
AMBER NICOLE TALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
5010 TROTWOOD AVE, COLUMBIA, TN 38401-5074
(931) 398-6300
Mailing address
5010 TROTWOOD AVE, COLUMBIA, TN 38401-5074
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2010
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2010
—
TN
Enumeration date
03/08/2019
Last updated
03/08/2019
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