Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 1733 | TN |
NPI | 1003489980 |
---|---|
Provider Name | Katy Lane Slaven |
First Address | Nashville, TN 37206-3614 |
Second Address | Nashville, TN 37206-3614 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2021 |
Last Update Date | 20/07/2021 |