| NPI | 1801227301 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALE EDWARD LYNN Occupational Threapist 270-688-8449 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics (Licence: KY 134498) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KY 005369) |
| 235Z00000X Speech-Language Pathologist, (Licence: KY 142037) | |
| Enumeration Date | 2013-12-09 |
| Last Update Date | 2016-11-10 |