Provider Demographics
NPI:1558707307
Name:LEVY, TRACEY FRIEDMAN (OTD, OTR/L)
Entity Type:Individual
Prefix:
First Name:TRACEY
Middle Name:FRIEDMAN
Last Name:LEVY
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:TRACEY
Other - Middle Name:ELLEN
Other - Last Name:FRIEDMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTD, OTR/L
Mailing Address - Street 1:6009 DEERBROOK DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37221-4095
Mailing Address - Country:US
Mailing Address - Phone:615-838-5800
Mailing Address - Fax:
Practice Address - Street 1:6009 DEERBROOK DR
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37221-4095
Practice Address - Country:US
Practice Address - Phone:615-838-5800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-21
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4763225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist