Provider Demographics
NPI:1457606071
Name:CHANEY, KATI BROOKE (COTA/L)
Entity Type:Individual
Prefix:
First Name:KATI
Middle Name:BROOKE
Last Name:CHANEY
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 1:2700 PARADISE DR
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:TN
Mailing Address - Zip Code:37174-7204
Mailing Address - Country:US
Mailing Address - Phone:731-445-0666
Mailing Address - Fax:
Practice Address - Street 1:216 FAIRGROUND ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-3531
Practice Address - Country:US
Practice Address - Phone:731-445-0666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-19
Last Update Date:2016-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2130224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant