Individual
MISS LYNNZE TAYLOR ETHRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTD, OTR/L
Contact information
Practice address
65 MOUSE CREEK RD NW, CLEVELAND, TN 37312-4840
(423) 476-7212
(423) 476-1673
Mailing address
65 MOUSE CREEK RD NW, CLEVELAND, TN 37312-4840
(423) 476-7212
(423) 476-1673
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
6299
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6299
STATE OF TN. LICENSE NUMBER
TN
Enumeration date
07/19/2019
Last updated
07/19/2019
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