Individual
MISS BAILEY A MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
101 S MAIN ST, CLINTON, TN 37716-3622
(865) 457-9157
Mailing address
128 HATMAKER RIDGE RD, JACKSBORO, TN 37757-4841
(423) 494-4313
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0000003677
TN
Other
Enumeration date
07/14/2022
Last updated
07/14/2022
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