Provider Demographics
NPI:1720568751
Name:CHAPMAN, ALEAHA (COTA/L)
Entity Type:Individual
Prefix:
First Name:ALEAHA
Middle Name:
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:156 BLUE BIRD RD
Mailing Address - Street 2:
Mailing Address - City:SUMMERTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38483-5101
Mailing Address - Country:US
Mailing Address - Phone:931-477-0931
Mailing Address - Fax:
Practice Address - Street 1:1311 S LOCUST AVE
Practice Address - Street 2:
Practice Address - City:LAWRENCEBURG
Practice Address - State:TN
Practice Address - Zip Code:38464-4040
Practice Address - Country:US
Practice Address - Phone:931-766-6374
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-20
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3127224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant