Provider Demographics
NPI:1710174735
Name:BIRD, PATRICIA G (OTR/L)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:G
Last Name:BIRD
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 1:4850 E ANDREW JOHNSON HWY
Mailing Address - Street 2:GVDC
Mailing Address - City:GREENEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37745-3098
Mailing Address - Country:US
Mailing Address - Phone:423-787-6504
Mailing Address - Fax:
Practice Address - Street 1:4850 E ANDREW JOHNSON HWY
Practice Address - Street 2:GVDC
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37745-3098
Practice Address - Country:US
Practice Address - Phone:423-787-6504
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-03
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3493225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist