Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251H1200X | Hand | ||
N | 225X00000X | Occupational Therapist | R0324 | KY |
NPI | 1861560161 |
---|---|
Provider Name | Beverly Parrish |
First Address | Cincinnati, OH 45264-0304 |
Second Address | Bowling Green, KY 42103-3402 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/12/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1760411342 | GROUP NPI (01) | KY |
GROUP # 91011148 | (05) | KY |