Individual
LISA DANIELLE TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3513 CHERE CAROL RD., HUMBOLDT, TN 38343
(731) 784-0545
Mailing address
194 BENT OAKS DR, JACKSON, TN 38305-6457
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
2967
TN
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
01/18/2019
Last updated
02/05/2019
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