Individual
JAYNE ANDREA HALLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
298 WARFIELD BLVD APT C, CLARKSVILLE, TN 37043-1896
(931) 906-0440
(931) 920-5070
Mailing address
298 WARFIELD BLVD APT C, CLARKSVILLE, TN 37043-1896
(931) 906-0440
(931) 920-5070
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3177
TN
Other
Enumeration date
01/23/2019
Last updated
01/23/2019
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