Individual
MRS. TABITHA LOUISE MECKLENBORG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
5321 BEVERLY PARK CIR, KNOXVILLE, TN 37918-9253
(865) 687-1321
Mailing address
1115 RALEIGH AVE, KNOXVILLE, TN 37917-3141
(931) 303-3764
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3128
TN
Other
Enumeration date
03/17/2019
Last updated
03/17/2019
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