Provider Demographics
NPI:1235340233
Name:TENNEY, EMILY M (OT)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:M
Last Name:TENNEY
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4111 COLE AVE
Mailing Address - Street 2:# 8
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-2093
Mailing Address - Country:US
Mailing Address - Phone:504-427-9114
Mailing Address - Fax:
Practice Address - Street 1:8615 FREEPORT PKWY
Practice Address - Street 2:SUITE 225
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-2576
Practice Address - Country:US
Practice Address - Phone:972-812-3299
Practice Address - Fax:866-861-4265
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111720225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist