Individual
MRS. MAGAN RENEE BRISSEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1842 WILMA RUDOPH BLVD, CLARKSVILLE, TN 37040
(931) 906-0440
(931) 920-5070
Mailing address
1842 WILMA RUDOPH BLVD, CLARKSVILLE, TN 37040
(931) 906-0440
(931) 920-5070
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1573
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1573
LICENSE TN
TN
Enumeration date
12/05/2007
Last updated
12/05/2007
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