Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | R5523 | KY |
NPI | 1861859266 |
---|---|
Provider Name | Alissa Cannoy |
First Address | Ashland, KY 41101-7734 |
Second Address | Ashland, KY 41101-7734 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/01/2016 |
Last Update Date | 01/11/2016 |