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NPI Code Detail

MEDICARE: MRS. KARLA RHEA STEVENS MS OTR/L

MEDICARE: MRS. KARLA RHEA STEVENS MS OTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225XP0200XPediatric Occupational Therapist056.003602IL
2225XP0200XPediatric Occupational Therapist4772TN

General Provider Information

NPI Number : 1366687048
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KARLA RHEA STEVENS MS OTR/L
Provider Business Mailing Address
First Line : 3658 LILLI FLORA LN
Second Line :
City : APISON
State : TN
Zip : 37302-1704
Country : US
Telephone Number : 630-212-8714
Fax Number : 630-212-8714
Provider Business Practice Location Address
First Line : 200 W MARTIN LUTHER KING BLVD STE 1000
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37402-2571
Country : US
Telephone Number : 630-212-8714
Fax Number : 800-470-1905
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2008
Last Update Date : 12/28/2020

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