Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | R4600 | KY |
NPI | 1629436944 |
---|---|
Provider Name | Devin Oak |
First Address | Louisville, KY 40243-1077 |
Second Address | Louisville, KY 40243-1077 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2016 |
Last Update Date | 01/02/2016 |