Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | BOTOCT00218945 | KY |
NPI | 1003297961 |
---|---|
Provider Name | Katie Flanigan |
First Address | Shelbyville, KY 40065-8141 |
Second Address | Shelbyville, KY 40065-8141 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2015 |
Last Update Date | 16/06/2015 |