Provider Demographics
NPI:1437392685
Name:HARRIS, TORREY WILSON (OTR/L)
Entity Type:Individual
Prefix:
First Name:TORREY
Middle Name:WILSON
Last Name:HARRIS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2150 WILMA RUDOLPH BLVD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37040-6675
Mailing Address - Country:US
Mailing Address - Phone:931-542-2168
Mailing Address - Fax:931-542-2206
Practice Address - Street 1:2150 WILMA RUDOLPH BLVD
Practice Address - Street 2:SUITE 2
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37040-6675
Practice Address - Country:US
Practice Address - Phone:931-542-2168
Practice Address - Fax:931-542-2206
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-16
Last Update Date:2009-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119003949225X00000X
TN4121225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist