Individual
WHITNEY MARIE REVELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
TENNESSEE STATE VETERAN'S HOME, 2865 E. MAIN ST., HUMBOLDT, TN 38343
(731) 784-8405
Mailing address
2281 LANIER RD, ALAMO, TN 38001-4958
(731) 345-0178
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
13005048
TN
Other
Enumeration date
03/10/2023
Last updated
03/10/2023
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