Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 273124 | KY |
NPI | 1326701657 |
---|---|
Provider Name | Emily Taylor Porter |
First Address | Campbellsville, KY 42718-9658 |
Second Address | Glasgow, KY 42141-3454 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2021 |
Last Update Date | 13/10/2021 |