Individual
MRS. BERNADETTE HACKWORTH NEEDHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
302 WESLEY ST, SUITE 8, JOHNSON CITY, TN 37601-1740
(423) 282-1700
Mailing address
329 EDGEWOOD ST, CHURCH HILL, TN 37642-4223
(423) 357-6258
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT0000002758
TN
Other
Enumeration date
09/18/2012
Last updated
09/18/2012
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