Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 3799 | TN |
NPI | 1417402777 |
---|---|
Provider Name | Trista Mcclarnon |
First Address | Nashville, TN 37211-4341 |
Second Address | Nashville, TN 37211-4341 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2016 |
Last Update Date | 16/08/2016 |