Individual
MADISON ELISE MOUNTJOY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
177 N HIGHLAND ST, MEMPHIS, TN 38111-4747
(901) 325-4000
Mailing address
177 N HIGHLAND ST, MEMPHIS, TN 38111
(901) 325-4000
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3492
TN
Other
Enumeration date
05/02/2021
Last updated
05/02/2021
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