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Individual

SUZANNE KENNERLY MERRITT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
505 N ROAN ST, JOHNSON CITY, TN 37601-4740
(980) 621-1042
Mailing address
410 SHADDEN RD, GRAY, TN 37615-4233
(980) 621-1042

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary

Other

Enumeration date
06/23/2021
Last updated
06/23/2021
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