Provider Demographics
NPI:1457621245
Name:GARNER, JILLIAN MICHELLE (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:JILLIAN
Middle Name:MICHELLE
Last Name:GARNER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MS
Other - First Name:JILLIAN
Other - Middle Name:MICHELLE
Other - Last Name:DEASON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:514 S BROWN ST
Mailing Address - Street 2:SUITE 600
Mailing Address - City:SPRINGFIELD
Mailing Address - State:TN
Mailing Address - Zip Code:37172-2937
Mailing Address - Country:US
Mailing Address - Phone:615-382-0500
Mailing Address - Fax:615-382-0501
Practice Address - Street 1:514 S BROWN ST
Practice Address - Street 2:SUITE 600
Practice Address - City:SPRINGFIELD
Practice Address - State:TN
Practice Address - Zip Code:37172-2937
Practice Address - Country:US
Practice Address - Phone:615-382-0500
Practice Address - Fax:615-382-0501
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-10
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3635225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist