Individual
ALISHIA ELLIS HEASTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
4603 CRADDLE HILL DR, BARTLETT, TN 38002-1501
(901) 487-2039
Mailing address
4603 CRADDLE HILL DR APT 206, BARTLETT, TN 38002-1501
(901) 487-2039
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2905
TN
Other
Enumeration date
09/10/2013
Last updated
06/14/2020
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