Provider Demographics
NPI:1518264126
Name:SWINNEY, DESIREE CHRISTINE (COTA)
Entity Type:Individual
Prefix:MS
First Name:DESIREE
Middle Name:CHRISTINE
Last Name:SWINNEY
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:751 OAKLAND DR
Mailing Address - Street 2:
Mailing Address - City:NEW JOHNSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37134-9671
Mailing Address - Country:US
Mailing Address - Phone:931-209-3388
Mailing Address - Fax:
Practice Address - Street 1:41 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:TN
Practice Address - Zip Code:38351-1423
Practice Address - Country:US
Practice Address - Phone:731-968-6629
Practice Address - Fax:731-967-0576
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-16
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1927224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant