Individual
MARIE ELLEN ABDU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
601 W BROADWAY ST, LENOIR CITY, TN 37771-2702
(865) 816-3611
(865) 816-6047
Mailing address
511 W BROADWAY ST, LENOIR CITY, TN 37771-2806
(865) 661-2785
(865) 816-6047
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
OTA0000000587
TN
225700000X
Massage Therapist
Primary
0000013128
TN
Other
Enumeration date
09/17/2006
Last updated
10/05/2020
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