Individual
MRS. SHELLEY PEVAHOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
895 POWERS BLVD, WAVERLY, TN 37185-1018
(931) 296-7552
Mailing address
1198 JOHNNY HALL RD, BURNS, TN 37029-5682
(615) 476-7385
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0000003064
TN
Other
Enumeration date
09/16/2009
Last updated
09/16/2009
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