Individual
JACKLON WILLIAMS TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1245 E COLLEGE ST, PULASKI, TN 38478-4541
(931) 363-7548
Mailing address
1245 E COLLEGE ST, PULASKI, PULASKI, TN 38478-4541
(931) 363-7548
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0533
TN
Other
Enumeration date
10/25/2006
Last updated
07/08/2007
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