Individual
MRS. TRICIA SHUDAN JENKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
307 N 5TH ST, MARYVILLE, TN 37804-2921
(865) 983-0261
Mailing address
307 N 5TH ST, MARYVILLE, TN 37804-2921
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0895
TN
Other
Enumeration date
08/26/2008
Last updated
08/26/2008
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