Organization
THE FUN IN FUNCTION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRESSOR SHADEL (BUSINESS MANAGER)
(423) 463-0683
Entity
Organization
Contact information
Practice address
6142 SHALLOWFORD RD STE 104, CHATTANOOGA, TN 37421-7216
(423) 463-0683
(423) 250-1651
Mailing address
6142 SHALLOWFORD RD STE 104, CHATTANOOGA, TN 37421-7216
(423) 463-0683
(423) 250-1651
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
—
—
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q059922
—
TN
Enumeration date
03/02/2020
Last updated
02/19/2021
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