Provider Demographics
NPI:1356756738
Name:LIFE OCCUPATIONAL THERAPY SERVICES, PLLC
Entity type:Organization
Organization Name:LIFE OCCUPATIONAL THERAPY SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARNIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:RILEY STRICKLAND
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:843-860-0541
Mailing Address - Street 1:621 N 9TH ST
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37206-3905
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:621 N 9TH ST
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37206-3905
Practice Address - Country:US
Practice Address - Phone:843-860-0541
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-24
Last Update Date:2014-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3706251E00000X, 251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3706OtherTN HEALTH RELATED BOARD