Provider Demographics
NPI:1386898195
Name:HUNT, TRACEY LEIGH (COTA/L)
Entity type:Individual
Prefix:
First Name:TRACEY
Middle Name:LEIGH
Last Name:HUNT
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 1:202 E MTCS RD
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-1524
Mailing Address - Country:US
Mailing Address - Phone:615-849-8748
Mailing Address - Fax:
Practice Address - Street 1:202 E MTCS RD
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-1524
Practice Address - Country:US
Practice Address - Phone:615-849-8748
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-06
Last Update Date:2008-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1751224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant