Provider Demographics
NPI:1609056399
Name:VANDERBILT CHILDREN'S
Entity Type:Organization
Organization Name:VANDERBILT CHILDREN'S
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:POWERS
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:615-936-0730
Mailing Address - Street 1:1702 THE VANDERBILT CLINIC
Mailing Address - Street 2:1301 22ND AVE SOUTH
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37232-0001
Mailing Address - Country:US
Mailing Address - Phone:615-936-0730
Mailing Address - Fax:615-936-7331
Practice Address - Street 1:1702 THE VANDERBILT CLINIC
Practice Address - Street 2:1301 22ND AVE SOUTH
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232-0001
Practice Address - Country:US
Practice Address - Phone:615-936-0730
Practice Address - Fax:615-936-7331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-09
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN282NC2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC2000XHospitalsGeneral Acute Care HospitalChildren