Individual
MRS. DAWN ANNETTE WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.T.R.
Contact information
Practice address
9020 COUNTRY DOWNS CV, CORDOVA, TN 38016-8473
(901) 382-6383
Mailing address
9020 COUNTRY DOWNS CV, CORDOVA, TN 38016-8473
(901) 745-7758
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT0000001276
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT0000001276
STATE LICENSURE NUMBER
TN
Enumeration date
11/04/2010
Last updated
11/04/2010
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