Provider Demographics
NPI:1861749897
Name:GILBERT-CHAFFIN, TAMMI SUE (COTA/L)
Entity type:Individual
Prefix:MRS
First Name:TAMMI
Middle Name:SUE
Last Name:GILBERT-CHAFFIN
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 1:117 PINECROFT CT
Mailing Address - Street 2:
Mailing Address - City:TROUTMAN
Mailing Address - State:NC
Mailing Address - Zip Code:28166-7618
Mailing Address - Country:US
Mailing Address - Phone:704-508-1905
Mailing Address - Fax:
Practice Address - Street 1:117 PINECROFT CT
Practice Address - Street 2:
Practice Address - City:TROUTMAN
Practice Address - State:NC
Practice Address - Zip Code:28166-7618
Practice Address - Country:US
Practice Address - Phone:704-508-1905
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-09
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7581224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant