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General NPI Number Information
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NPI Number | 1831952084
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Entity Type | Individual
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Provider Name | LAUREN LAMBERTUCCI
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Gender | Female
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Dates
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Enumeration Date | 01/31/2024
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Last Update Date | 01/31/2024
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Provider Practice Location Address
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Address Line | 318 WOODSBORO LN
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City | MARYVILLE
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State | TN
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Zip | 37804-3689
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Country | US
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Telephone | 865-410-0866
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Fax |
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Provider Business Mailing Address
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Address Line | 2304 E LAMAR ALEXANDER PKWY
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City | MARYVILLE
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State | TN
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Zip | 37804-5316
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Country | US
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Telephone | 865-980-6000
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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 | 4073
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License Number State | TN
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