Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | OT005325 | GA |
NPI | 1013291848 |
---|---|
Provider Name | Lindsey Kenny |
First Address | Calhoun, GA 30701-3075 |
Second Address | Calhoun, GA 30701-3075 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2011 |
Last Update Date | 28/09/2011 |