Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner |
NPI | 1043642572 |
---|---|
Provider Name | Daria Hall |
First Address | Louisville, KY 40202-1423 |
Second Address | Louisville, KY 40220-2340 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2013 |
Last Update Date | 07/08/2013 |