Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 6630 | TN |
NPI | 1457960288 |
---|---|
Provider Name | Lauren Miller Crowder |
First Address | Memphis, TN 38114-1713 |
Second Address | Memphis, TN 38111-4747 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2020 |
Last Update Date | 28/07/2020 |