Provider Demographics
NPI:1730462516
Name:CLAWSON, NIMISHA SHAH (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:NIMISHA
Middle Name:SHAH
Last Name:CLAWSON
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 1:7480 WILLEY RD
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-2818
Mailing Address - Country:US
Mailing Address - Phone:901-248-9388
Mailing Address - Fax:
Practice Address - Street 1:7480 WILLEY RD
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-2818
Practice Address - Country:US
Practice Address - Phone:901-248-9388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-27
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000001828225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist