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General NPI Number Information
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NPI Number | 1942926779
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Entity Type | Organization
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Legal Business Name | ACHIEVING INDEPENDENCE OCCUPATIONAL THERAPY
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Dates
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Enumeration Date | 10/13/2022
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Last Update Date | 10/13/2022
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Provider Practice Location Address
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Address Line | 1842 EAGLE BRANCH CV APT 2
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City | GERMANTOWN
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State | TN
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Zip | 38138-3149
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Country | US
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Telephone | 901-212-2451
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Fax |
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Provider Business Mailing Address
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Address Line | 1842 EAGLE BRANCH CV APT 2
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City | GERMANTOWN
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State | TN
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Zip | 38138-3149
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Country | US
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Telephone | 901-212-2451
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Fax |
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPIST
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Name | DIANE MARIE KOLESAR
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Credential | OTR/L
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Telephone | 901-212-2451
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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 |
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License Number State |
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