Provider Demographics
NPI:1114327533
Name:GEER, DANIELLE AMANDA (COTA)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:AMANDA
Last Name:GEER
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 1:835 SOUTHGATE DR
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-3849
Mailing Address - Country:US
Mailing Address - Phone:931-261-5970
Mailing Address - Fax:
Practice Address - Street 1:444 ONE ELEVEN PL
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38506-4358
Practice Address - Country:US
Practice Address - Phone:931-525-6655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-04
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2452224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant