Provider Demographics
NPI:1093060758
Name:OZMENT, COURTNEY LANE (OTR/L)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:LANE
Last Name:OZMENT
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:LANE
Other - Last Name:BURTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:145 COUNTRYVIEW LN
Mailing Address - Street 2:
Mailing Address - City:DYERSBURG
Mailing Address - State:TN
Mailing Address - Zip Code:38024-7763
Mailing Address - Country:US
Mailing Address - Phone:731-676-8289
Mailing Address - Fax:
Practice Address - Street 1:1900 PARR AVE
Practice Address - Street 2:
Practice Address - City:DYERSBURG
Practice Address - State:TN
Practice Address - Zip Code:38024-2009
Practice Address - Country:US
Practice Address - Phone:731-286-1221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-18
Last Update Date:2012-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4614225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist