Provider Demographics
NPI:1780399584
Name:GILBERT, CHESNEY MICHAELA (COTA/L)
Entity type:Individual
Prefix:
First Name:CHESNEY
Middle Name:MICHAELA
Last Name:GILBERT
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 1:792 JIM PRESSNELL RD
Mailing Address - Street 2:
Mailing Address - City:TAZEWELL
Mailing Address - State:TN
Mailing Address - Zip Code:37879-4235
Mailing Address - Country:US
Mailing Address - Phone:865-585-1015
Mailing Address - Fax:
Practice Address - Street 1:914 INDUSTRIAL PARK RD
Practice Address - Street 2:
Practice Address - City:DANDRIDGE
Practice Address - State:TN
Practice Address - Zip Code:37725-4700
Practice Address - Country:US
Practice Address - Phone:865-397-3333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-17
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNOTA0000003813224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant