Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | R0263 | KY |
N | 225XE0001X | Environmental Modification | R0263 | KY |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | R0263 | KY |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | R0263 | KY |
NPI | 1073985974 |
---|---|
Provider Name | Cynthia K Donner |
First Address | La Grange, KY 40031-8037 |
Second Address | La Grange, KY 40031-8037 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/10/2015 |
Last Update Date | 06/05/2016 |