Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 172232 | KY |
NPI | 1013484302 |
---|---|
Provider Name | Lacey Briggs |
First Address | Owensboro, KY 42303-1799 |
Second Address | Owensboro, KY 42303-1799 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2018 |
Last Update Date | 25/10/2018 |