Organization
WEST TENNESSEE CEREBRAL PALSY ASSOCIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY M PRESCOTT (CFO)
(731) 668-3322
Entity
Organization
Contact information
Practice address
34 GARLAND DR, JACKSON, TN 38305-3654
(731) 668-3322
(731) 664-2992
Mailing address
34 GARLAND DR, JACKSON, TN 38305-3654
(731) 668-3322
(731) 664-2992
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
PSS0000000110
TN
225XP0200X
Pediatric Occupational Therapist
PSS0000000110
TN
235Z00000X
Speech-Language Pathologist
Primary
PSS0000000110
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
117255
UNISON
TN
01
—
13886
TLC
TN
01
—
30997
BCBS TENNESSEE SELECT
TN
05
—
446656
—
TN
Enumeration date
08/30/2006
Last updated
09/11/2025
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