Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | A3732 | KY |
NPI | 1033301791 |
---|---|
Provider Name | Achsah Cybill Martin |
First Address | Owensboro, KY 42301-6743 |
Second Address | Owensboro, KY 42303-3258 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2007 |
Last Update Date | 15/08/2007 |