Provider Demographics
NPI:1700502689
Name:PEMAJ, ARVIOLA (OTR/L)
Entity Type:Individual
Prefix:
First Name:ARVIOLA
Middle Name:
Last Name:PEMAJ
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 1:111 ACKLEN PARK DR APT 470
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1191
Mailing Address - Country:US
Mailing Address - Phone:773-226-6845
Mailing Address - Fax:
Practice Address - Street 1:115 WOODMONT BLVD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-2280
Practice Address - Country:US
Practice Address - Phone:615-997-3030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-12
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6977225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist