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General NPI Number Information
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NPI Number | 1730902065
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Entity Type | Individual
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Provider Name | TAYLOR CAMPBELL OTD, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 11/05/2024
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Last Update Date | 11/05/2024
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Provider Practice Location Address
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Address Line | 2745 EXECUTIVE PARK NW
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City | CLEVELAND
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State | TN
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Zip | 37312-2723
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Country | US
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Telephone | 423-961-3534
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Fax |
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Provider Business Mailing Address
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Address Line | 8417 OAK VIEW DR
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City | CHATTANOOGA
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State | TN
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Zip | 37421-4377
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Country | US
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Telephone | 615-260-7110
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 5718
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License Number State | TN
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