Individual
UBOLWAN WAYNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
900 PROFESSIONAL PARK DR, CLARKSVILLE, TN 37040-5136
(931) 552-3002
Mailing address
817 BURTON TRL, ADAMS, TN 37010-8938
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0936
TN
Other
Enumeration date
05/03/2010
Last updated
05/03/2010
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