Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 171461 | KY |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 171461 | KY |
NPI | 1316421241 |
---|---|
Provider Name | Julie Ann Korn |
First Address | Fisherville, KY 40023-7774 |
Second Address | Fisherville, KY 40023-7774 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/09/2018 |
Last Update Date | 29/01/2020 |