Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 1267 | TN |
NPI | 1013091891 |
---|---|
Provider Name | Julie Lynn Calvin |
First Address | Antioch, TN 37013-2621 |
Second Address | Franklin, TN 37067-7242 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2006 |
Last Update Date | 08/07/2007 |