Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT000005122 | TN |
N | 225X00000X | Occupational Therapist | OT003665 | GA |
N | 225X00000X | Occupational Therapist | OTP-OT-LIC 3357 | MT |
NPI | 1003361254 |
---|---|
Provider Name | Marla Orr |
First Address | Hermitage, TN 37076-5629 |
Second Address | Hermitage, TN 37076-5629 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2016 |
Last Update Date | 17/08/2016 |