Provider Demographics
NPI:1043474240
Name:AUSTIN, EVA MARIE (OTR)
Entity Type:Individual
Prefix:
First Name:EVA
Middle Name:MARIE
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1397 S COLLEGE ST
Mailing Address - Street 2:P. O. BOX 4
Mailing Address - City:WINCHESTER
Mailing Address - State:TN
Mailing Address - Zip Code:37398-2414
Mailing Address - Country:US
Mailing Address - Phone:931-962-3225
Mailing Address - Fax:931-962-3103
Practice Address - Street 1:1397 S COLLEGE ST
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:TN
Practice Address - Zip Code:37398-2414
Practice Address - Country:US
Practice Address - Phone:931-962-3225
Practice Address - Fax:931-962-3103
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-16
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNOT0000000319225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist