Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | KY-R4327 | KY |
NPI | 1003121054 |
---|---|
Provider Name | Amanda E Sturm |
First Address | Paducah, KY 42001-9499 |
Second Address | Paducah, KY 42001-9499 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2010 |
Last Update Date | 30/06/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
KY-R4327 | KENTUCKY BOARD OF LICENSURE FOR OCCUPATIONAL THERHAPY (01) | KY |