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Individual

MS. MELODIE SUE PERRY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS, OTR/L

Contact information

Practice address
1319 SUNSET DR, SUITE 102, JOHNSON CITY, TN 37604-3799
(423) 915-6307
(423) 328-8662
Mailing address
PO BOX 191, JOHNSON CITY, TN 37605-0191
(423) 915-6307
(423) 328-8662

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
0119006020
VA
225X00000X
Occupational Therapist
Primary
4137
TN
225XP0200X
Pediatric Occupational Therapist
0119006020
VA
225XP0200X
Pediatric Occupational Therapist
4137
TN
251C00000X
Developmentally Disabled Services Day Training Agency
0119006020
VA
252Y00000X
Early Intervention Provider Agency
0119006020
VA

Other

Enumeration date
05/07/2013
Last updated
09/11/2014
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