Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 3486 | TN |
NPI | 1003568486 |
---|---|
Provider Name | Ariana Musolino |
First Address | Hermitage, TN 37076-1316 |
Second Address | Mt Juliet, TN 37122-7206 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2022 |
Last Update Date | 26/01/2022 |