MEDICARE: MECHELLE R DEKMAR 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	1774	TN

General Provider Information

NPI Number	:	1528234853
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MECHELLE R DEKMAR OTR/L

Provider Business Mailing Address
First Line	:	2040 EARL PEARCE CIR
Second Line	:
City	:	MOUNT JULIET
State	:	TN
Zip	:	37122-1327
Country	:	US
Telephone Number	:	615-754-4143
Fax Number	:

Provider Business Practice Location Address
First Line	:	2040 EARL PEARCE CIR
Second Line	:
City	:	MOUNT JULIET
State	:	TN
Zip	:	37122-1327
Country	:	US
Telephone Number	:	615-754-4143
Fax Number	:

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

Provider Enumeration Date	:	05/06/2008
Last Update Date	:	06/21/2026

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