Healthcare Provider Details

I. General information

NPI: 1205544459
Provider Name (Legal Business Name): TENDRILS THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2022
Last Update Date: 11/07/2022
Certification Date: 11/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2315 CANNON AVE STE 103
CHATTANOOGA TN
37408-2716
US

IV. Provider business mailing address

2315 CANNON AVE STE 103
CHATTANOOGA TN
37408-2716
US

V. Phone/Fax

Practice location:
  • Phone: 423-413-8378
  • Fax: 800-470-1905
Mailing address:
  • Phone:
  • Fax: 800-470-1905

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER PEET
Title or Position: OWNER
Credential:
Phone: 423-413-8378