Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant |
NPI | 1003581232 |
---|---|
Provider Name | Mary Rita Hayden |
First Address | Greenbrier, TN 37073-2121 |
Second Address | Gallatin, TN 37066-3003 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2021 |
Last Update Date | 12/08/2021 |