Individual
MELISSA MARIE BLUME
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
3300 N BROADWAY ST, KNOXVILLE, TN 37917-2733
(865) 686-7300
Mailing address
7516 WICKAM RD, KNOXVILLE, TN 37931-1760
(865) 228-7524
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1862
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1862
TENNESSEE DEPARTMENT OF HEALTH/BOARD OF OCCUPATIONAL THERAPY STATE LICENSE
TN
Enumeration date
09/15/2022
Last updated
09/15/2022
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