Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | OT0000002287 | TN |
NPI | 1063064301 |
---|---|
Provider Name | Janice K Ryan |
First Address | Chattanooga, TN 37415-6221 |
Second Address | Chattanooga, TN 37415-6520 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2019 |
Last Update Date | 16/07/2019 |