Individual
STEVEN RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
815 S WALNUT AVE, COOKEVILLE, TN 38501-5956
(931) 528-5516
Mailing address
815 S WALNUT AVE, COOKEVILLE, TN 38501-5956
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3040
TN
Other
Enumeration date
07/17/2018
Last updated
07/17/2018
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