Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 2444 | TN |
NPI | 1003205733 |
---|---|
Provider Name | Taryn Lentchner |
First Address | Johnson City, TN 37605-0191 |
Second Address | Johnson City, TN 37604-7907 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2015 |
Last Update Date | 19/01/2015 |