Provider Demographics
NPI:1548941446
Name:MORGAN, KENNEDY MCCLAIN (OTD, OTR/L)
Entity type:Individual
Prefix:MRS
First Name:KENNEDY
Middle Name:MCCLAIN
Last Name:MORGAN
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:KENNEDY
Other - Middle Name:MCCLAIN
Other - Last Name:HILLIARD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTD, OTR/L
Mailing Address - Street 1:1237 MURRAY CT
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37087-5630
Mailing Address - Country:US
Mailing Address - Phone:615-504-7054
Mailing Address - Fax:
Practice Address - Street 1:110 BABB DR
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087-2506
Practice Address - Country:US
Practice Address - Phone:615-547-6008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-25
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7734225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics