MEDICARE: DIANE ELAINE GAFFNEY OTR, FAOTA

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
1	225X00000X	Occupational Therapist	22	TN

General Provider Information

NPI Number	:	1932241643
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANE ELAINE GAFFNEY OTR, FAOTA

Provider Business Mailing Address
First Line	:	2251 NEW HOPE RD
Second Line	:
City	:	CELINA
State	:	TN
Zip	:	38551-6170
Country	:	US
Telephone Number	:	931-258-4386
Fax Number	:

Provider Business Practice Location Address
First Line	:	2251 NEW HOPE RD
Second Line	:
City	:	CELINA
State	:	TN
Zip	:	38551-6170
Country	:	US
Telephone Number	:	931-267-0027
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/12/2007
Last Update Date	:	07/08/2007

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