Individual
MARIE SUZANNE TUTTEROW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
2700 S ROAN ST, JOHNSON CITY, TN 37601-7556
(317) 460-9664
Mailing address
1205 E 8TH AVE APT 1, JOHNSON CITY, TN 37601-3478
(317) 460-9664
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
7516
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7516
TN BOARD OF HEALTH
TN
Enumeration date
01/02/2023
Last updated
01/02/2023
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