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General NPI Number Information
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NPI Number | 1275803009
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Entity Type | Individual
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Provider Name | BEVERLY ANN HOPPENWORTH C.O.T.A./L.
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Gender | Female
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Dates
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Enumeration Date | 01/10/2012
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Last Update Date | 01/10/2012
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Provider Practice Location Address
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Address Line | 120 CAVETTE HILL LN
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City | KNOXVILLE
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State | TN
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Zip | 37934-6673
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Country | US
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Telephone | 865-777-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 1310 RIPLEY DR
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City | MARYVILLE
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State | TN
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Zip | 37803-9204
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Country | US
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Telephone | 865-406-8296
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 0000000584
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License Number State | TN
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