Individual
MS. SELENE W DISMUKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA L
Contact information
Practice address
NHC SCOTT, BUFFALO RD, LAWERENCEBURG, TN 38464
(931) 762-9418
(931) 766-0573
Mailing address
73 LODI RD, WESTPOINT, TN 38486
(931) 766-0287
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA951
TN
Other
Enumeration date
12/18/2006
Last updated
07/08/2007
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