Provider Demographics
NPI:1407469810
Name:PEDRO, ALANNA (OTR)
Entity Type:Individual
Prefix:
First Name:ALANNA
Middle Name:
Last Name:PEDRO
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2122 WATERTOWN PL
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-2101
Mailing Address - Country:US
Mailing Address - Phone:731-819-3285
Mailing Address - Fax:
Practice Address - Street 1:3326 ASPEN GROVE DR STE 312
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-4847
Practice Address - Country:US
Practice Address - Phone:615-651-4833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-25
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6620225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist