Provider Demographics
NPI:1124440094
Name:CIACELLI, PAULA JEAN (OT L)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:JEAN
Last Name:CIACELLI
Suffix:
Gender:F
Credentials:OT L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 ISAIAH CIR
Mailing Address - Street 2:
Mailing Address - City:SEYMOUR
Mailing Address - State:TN
Mailing Address - Zip Code:37865-5062
Mailing Address - Country:US
Mailing Address - Phone:865-594-4449
Mailing Address - Fax:
Practice Address - Street 1:912 S GAY ST
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37902-1814
Practice Address - Country:US
Practice Address - Phone:865-594-1540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-13
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN199225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist