Provider Demographics
NPI:1285345868
Name:DEAN, SAVANNAH GRACE (COTA/L)
Entity type:Individual
Prefix:MRS
First Name:SAVANNAH
Middle Name:GRACE
Last Name:DEAN
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:MRS
Other - First Name:SAVANNAH
Other - Middle Name:
Other - Last Name:JARRATT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:624 BRADFORD DR
Mailing Address - Street 2:
Mailing Address - City:GALLATIN
Mailing Address - State:TN
Mailing Address - Zip Code:37066-6150
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:140 THORNE BLVD
Practice Address - Street 2:
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-1509
Practice Address - Country:US
Practice Address - Phone:615-290-7586
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-06
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3887224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3887OtherTN DEPARTMENT OF HEALTH
TN478933OtherNBCOTA