Individual
STACEY TRENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
11396 PETE CARR RIDGE RD, SILVER POINT, TN 38582
(615) 489-3151
Mailing address
6161 BURGESS FALLS RD, SPARTA, TN 38583-5158
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4407
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q036185
—
TN
Enumeration date
07/19/2011
Last updated
08/21/2018
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