Healthcare Provider Details

I. General information

NPI: 1548627235
Provider Name (Legal Business Name): MARILYN HOBBS OT/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2016
Last Update Date: 01/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 ELMHURST DR
OAK RIDGE TN
37830-7621
US

IV. Provider business mailing address

3037 DIXIE LEE CIR
LENOIR CITY TN
37772-5488
US

V. Phone/Fax

Practice location:
  • Phone: 865-481-3367
  • Fax: 865-482-2474
Mailing address:
  • Phone: 865-388-5991
  • Fax: 865-986-9059

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: