Healthcare Provider Details

I. General information

NPI: 1316221922
Provider Name (Legal Business Name): TASSEY GARRETT MS, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2011
Last Update Date: 09/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 WAVELAND AVE
WINCHESTER KY
40391-1231
US

IV. Provider business mailing address

9 WAVELAND AVE
WINCHESTER KY
40391-1231
US

V. Phone/Fax

Practice location:
  • Phone: 855-584-5845
  • Fax: 800-584-1465
Mailing address:
  • Phone: 855-584-5845
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberR3559
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: