Provider Demographics
NPI:1376557876
Name:YEARY, TAMMY (OT)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:
Last Name:YEARY
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 1:885 RONALD DR
Mailing Address - Street 2:
Mailing Address - City:TALBOTT
Mailing Address - State:TN
Mailing Address - Zip Code:37877-8342
Mailing Address - Country:US
Mailing Address - Phone:423-748-4800
Mailing Address - Fax:
Practice Address - Street 1:1450 PIN OAK DR
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37814-1432
Practice Address - Country:US
Practice Address - Phone:423-748-4800
Practice Address - Fax:423-585-5889
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2767225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist