Individual
MRS. TERESA MARIE JENKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1850 EXECUTIVE PARK NW STE A, CLEVELAND, TN 37312-2700
(423) 473-8886
Mailing address
619 EADS BLUFF RD NW, GEORGETOWN, TN 37336-4940
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA2142
TN
Other
Enumeration date
10/31/2018
Last updated
10/31/2018
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