Provider Demographics
NPI:1417155649
Name:HOWELL, ALEATHIA DAYETTE (OTA)
Entity Type:Individual
Prefix:
First Name:ALEATHIA
Middle Name:DAYETTE
Last Name:HOWELL
Suffix:
Gender:F
Credentials:OTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 LAKESIDE PARK DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-4811
Mailing Address - Country:US
Mailing Address - Phone:615-826-9765
Mailing Address - Fax:
Practice Address - Street 1:813 S DICKERSON RD
Practice Address - Street 2:
Practice Address - City:GOODLETTSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37072-1761
Practice Address - Country:US
Practice Address - Phone:615-859-6600
Practice Address - Fax:615-859-6008
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2007-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN265224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant