Individual
CRYSTAL MICHELLE MEALER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
381 LEE RD, CLINTON, TN 37716-4239
(865) 264-4511
(865) 264-4511
Mailing address
381 LEE RD, CLINTON, TN 37716-4239
(865) 264-4511
(865) 264-4511
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT0000002970
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
618038400
DEEOIC DEPARTMENT OF LABOR PROVIDER
TN
Enumeration date
01/14/2015
Last updated
01/14/2015
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