Healthcare Provider Details

I. General information

NPI: 1578476693
Provider Name (Legal Business Name): HEATHER LIVINGSTON
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2892 S CHURCH ST STE A
MURFREESBORO TN
37127-6305
US

IV. Provider business mailing address

2892 S CHURCH ST STE A
MURFREESBORO TN
37127-6305
US

V. Phone/Fax

Practice location:
  • Phone: 615-447-9520
  • Fax:
Mailing address:
  • Phone: 615-447-9520
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number2595
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: