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NPI 1548941446

NPI 1548941446 : KENNEDY MCCLAIN MORGAN OTD, OTR/L : LEBANON, TN

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General NPI Number Information
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    NPI Number           |    1548941446
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    Entity Type          |    Individual 
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    Provider Name        |    KENNEDY MCCLAIN MORGAN OTD, OTR/L
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/25/2023
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    Last Update Date     |    07/25/2023
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Provider Practice Location Address
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    Address Line         |    110 BABB DR 
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    City                 |    LEBANON
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    State                |    TN
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    Zip                  |    37087-2506
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    Country              |    US
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    Telephone            |    615-547-6008
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1237 MURRAY CT 
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    City                 |    LEBANON
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    State                |    TN
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    Zip                  |    37087-5630
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    Country              |    US
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    Telephone            |    615-504-7054
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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        |    225XP0200X
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    Taxonomy Name        |    Pediatric Occupational Therapist
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    License Number       |    7734
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    License Number State |    TN
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