Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | R4964 | KY |
NPI | 1003169343 |
---|---|
Provider Name | Megan Brittany Young |
First Address | Nicholasville, KY 40356 |
Second Address | Nicholasville, KY 40356 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2012 |
Last Update Date | 02/12/2013 |