Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 006965 | KY |
NPI | 1043656945 |
---|---|
Provider Name | Jessica Nicole Raspen |
First Address | Lexington, KY 40503-1601 |
Second Address | Lexington, KY 40503-1601 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2013 |
Last Update Date | 29/04/2020 |