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General NPI Number Information
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NPI Number | 1881216810
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Entity Type | Individual
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Provider Name | SALLY HABIB
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Gender | Female
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Dates
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Enumeration Date | 05/13/2020
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Last Update Date | 05/13/2020
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Provider Practice Location Address
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Address Line | 202 WALTON FERRY RD
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City | HENDERSONVILLE
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State | TN
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Zip | 37075-3501
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Country | US
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Telephone | 615-822-7520
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Fax |
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Provider Business Mailing Address
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Address Line | 1464 STATION FOUR LN
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City | OLD HICKORY
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State | TN
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Zip | 37138-2353
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Country | US
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Telephone | 615-218-9174
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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 | 4526
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License Number State | TN
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