Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. BLAKE WALLACE
Active Sole ProprietorMR. BLAKE WALLACE is a Occupational Therapy Assistant healthcare provider located in GERMANTOWN, Tennessee. NPI 1821617663 is currently active in the NPPES registry. Verify at CMS.
Occupational Therapy Assistant · GERMANTOWN, TN
Registration Details
- NPI Number
- 1821617663
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Apr 12, 2020 (6.3002834981911 yrs)
- Last Updated
- Apr 12, 2020
- License
-
TA3704 (MS)
- Sole Proprietor
- Yes
Practice Information
- Address
-
7820 WALKING HORSE CIRGERMANTOWN, TN, 381382143Browse TN providers · Browse ZIP 38138
- Phone
- 9017522500
- Primary Specialty
-
Occupational Therapy Assistant
224Z00000X
Other Occupational Therapy Assistant Providers in GERMANTOWN, TN
| Name | Credential | NPI |
|---|---|---|
| MRS. CINDY RAE VINCENT | COTA | 1225276538 |
| KIMBERLY CAMPBELL | — | 1487053609 |
| JORDYN POTTER | — | 1538643556 |
| SHARNIKA THOMAS | — | 1356992002 |
| TERESA ANTHONY | COTA | 1720627813 |
| LAUREN ELIZABETH HOWLAND | — | 1174156335 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.