Provider Demographics
NPI:1710586292
Name:IYER, ISHA
Entity Type:Individual
Prefix:
First Name:ISHA
Middle Name:
Last Name:IYER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3326 ASPEN GROVE DR STE 312
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-4847
Mailing Address - Country:US
Mailing Address - Phone:615-651-4833
Mailing Address - Fax:
Practice Address - Street 1:3326 ASPEN GROVE DR STE 312
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-4847
Practice Address - Country:US
Practice Address - Phone:615-651-4833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-26
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024734-01225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY024734-01OtherUNIVERSITY OF THE STATE OF NEW YORK EDUCATION DEPARTMENT