Individual
MS. JESSICA FAULKNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1204 FRYE ST, ATHENS, TN 37303-3052
(423) 745-0434
Mailing address
708 W 3RD AVE, LENOIR CITY, TN 37771-2219
(865) 604-3169
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1579
TN
Other
Enumeration date
09/17/2006
Last updated
07/08/2007
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