Healthcare Provider Details

I. General information

NPI: 1679255038
Provider Name (Legal Business Name): ADELE HEATH OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2023
Last Update Date: 10/15/2024
Certification Date: 10/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 W MORRIS BLVD
MORRISTOWN TN
37813-2237
US

IV. Provider business mailing address

325 W MORRIS BLVD
MORRISTOWN TN
37813-2237
US

V. Phone/Fax

Practice location:
  • Phone: 423-317-7772
  • Fax: 423-317-7773
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number1210
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: