MEDICARE: MRS. ALYSON BROOKE EDWARDS OTD, OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	8373	TN

General Provider Information

NPI Number	:	1255261434
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ALYSON BROOKE EDWARDS OTD, OTR/L

Provider Business Mailing Address
First Line	:	647 CORONADO CREST RD
Second Line	:
City	:	MARYVILLE
State	:	TN
Zip	:	37804-3089
Country	:	US
Telephone Number	:	304-638-6998
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 FORT SANDERS WEST BLVD
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37922-3342
Country	:	US
Telephone Number	:	865-895-3000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/20/2026
Last Update Date	:	05/20/2026

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