Provider Demographics
NPI:1417508409
Name:HARCROW, MADELINE DUVALL (OTD, OTR/L)
Entity Type:Individual
Prefix:
First Name:MADELINE
Middle Name:DUVALL
Last Name:HARCROW
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 LASALLE CT
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-3762
Mailing Address - Country:US
Mailing Address - Phone:813-846-3399
Mailing Address - Fax:
Practice Address - Street 1:8353 HIGHWAY 100
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37221-4190
Practice Address - Country:US
Practice Address - Phone:629-888-5800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-22
Last Update Date:2019-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6261225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN419442OtherNBCOT
TN6261OtherTENNESSEE BOARD OF OCCUPATIONAL THERAPY