Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251E1200X | Ergonomics | 134379 | KY |
N | 225XE1200X | Ergonomics | 134379 | KY |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 134379 | KY |
Y | 225XP0200X | Occupational Therapist - Pediatrics | 134379 | KY |
NPI | 1659804813 |
---|---|
Provider Name | Karen Marie Whittaker-Clark |
First Address | Richmond, KY 40475-7924 |
Second Address | Richmond, KY 40475-7924 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2017 |
Last Update Date | 05/04/2017 |