Individual
LELIA WAYCASTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
629 W ELK AVE, ELIZABETHTON, TN 37643-2559
(423) 722-2062
(678) 494-6908
Mailing address
1028 KNOB CREEK RD, JOHNSON CITY, TN 37604-5343
(423) 291-1411
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
225XP0200X
Pediatric Occupational Therapist
3826
TN
Other
Enumeration date
03/07/2007
Last updated
03/04/2008
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