Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | R2738 | KY |
Y | 225XH1200X | Occupational Therapist - Hand | R2738 | KY |
NPI | 1033383914 |
---|---|
Provider Name | Betty J Lay |
First Address | Louisville, KY 40202-3838 |
Second Address | Louisville, KY 40202-3838 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2008 |
Last Update Date | 21/10/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7100113420 | (05) | KY |