Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | ||
N | 224Z00000X | Occupational Therapy Assistant | 2303 | TN |
NPI | 1013472034 |
---|---|
Provider Name | Sarah Clay |
First Address | Knoxville, TN 37918-9253 |
Second Address | Knoxville, TN 37918-9253 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/02/2019 |
Last Update Date | 12/02/2019 |