Provider Demographics
NPI:1346026580
Name:GIVENS, KELLY P (OTR/L)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:P
Last Name:GIVENS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3202 LAKEFORD DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37214-4221
Mailing Address - Country:US
Mailing Address - Phone:732-500-8760
Mailing Address - Fax:
Practice Address - Street 1:435 NW RUTLAND RD
Practice Address - Street 2:
Practice Address - City:MT JULIET
Practice Address - State:TN
Practice Address - Zip Code:37122-8700
Practice Address - Country:US
Practice Address - Phone:615-773-6111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-05
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7673225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist