Healthcare Provider Details
I. General information
NPI: 1346101201
Provider Name (Legal Business Name): KASSIE TANNEHILL THERAPY SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/20/2025
Last Update Date: 03/06/2026
Certification Date: 03/06/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1730 S FOURTH ST
JENA LA
71342-4084
US
IV. Provider business mailing address
109 DESPERADO RD
TROUT LA
71371-4501
US
V. Phone/Fax
- Phone: 318-316-3020
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
KASSIE
TANNEHILL
Title or Position: OCCUPATIONAL THERAPIST/OWNER
Credential: L/OTR
Phone: 318-316-3020