Healthcare Provider Details

I. General information

NPI: 1700706157
Provider Name (Legal Business Name): ACE'S INTEGRATED OCCUPATIONAL THERAPY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4029 LAVERGNE COUCHVILLE PIKE
ANTIOCH TN
37013-1402
US

IV. Provider business mailing address

4029 LAVERGNE COUCHVILLE PIKE
ANTIOCH TN
37013-1402
US

V. Phone/Fax

Practice location:
  • Phone: 615-943-1515
  • Fax: 615-793-7307
Mailing address:
  • Phone: 615-943-1515
  • Fax: 615-793-7307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: MARIAH PRISCILLAH PETTIT
Title or Position: CEO
Credential: MED,
Phone: 615-943-1515