Healthcare Provider Details

I. General information

NPI: 1184532731
Provider Name (Legal Business Name): CLAIRE CLEMMONS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1043 EXECUTIVE DR STE 101
HIXSON TN
37343-3998
US

IV. Provider business mailing address

1043 EXECUTIVE DR STE 101
HIXSON TN
37343-3998
US

V. Phone/Fax

Practice location:
  • Phone: 423-708-4445
  • Fax: 423-443-3000
Mailing address:
  • Phone: 423-708-4445
  • Fax: 423-443-3000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number8834
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: