Provider Demographics
NPI:1003581232
Name:HAYDEN, MARY RITA (COTA)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:RITA
Last Name:HAYDEN
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5615 NEW CUT RD
Mailing Address - Street 2:
Mailing Address - City:GREENBRIER
Mailing Address - State:TN
Mailing Address - Zip Code:37073-2121
Mailing Address - Country:US
Mailing Address - Phone:615-243-2060
Mailing Address - Fax:
Practice Address - Street 1:555 E BLEDSOE ST
Practice Address - Street 2:
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-3003
Practice Address - Country:US
Practice Address - Phone:615-452-7132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-10
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant