Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | KY-A3958 | KY |
NPI | 1043568041 |
---|---|
Provider Name | Jennifer Rowlett |
First Address | Vienna, IL 62995-3016 |
Second Address | Paducah, KY 42001-4075 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2012 |
Last Update Date | 22/08/2012 |