Provider Demographics
NPI:1346461910
Name:KADOW, TAMYRA LYNN (MS,OTRL,CHT)
Entity Type:Individual
Prefix:
First Name:TAMYRA
Middle Name:LYNN
Last Name:KADOW
Suffix:
Gender:F
Credentials:MS,OTRL,CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1422 OLD WEISGARBER RD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-1293
Mailing Address - Country:US
Mailing Address - Phone:865-558-4480
Mailing Address - Fax:865-558-4481
Practice Address - Street 1:1422 OLD WEISGARBER RD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-1293
Practice Address - Country:US
Practice Address - Phone:865-558-4480
Practice Address - Fax:865-558-4481
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2017-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000003080225XH1200X
TN3080225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1523185Medicaid
P01085924OtherRAILROAD MEDICARE
TN4869322OtherCIGNA
TN4317886OtherBLUECROSS BLUESHEILD
TN4869322OtherCIGNA