Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 132611 | KY |
N | 225XE0001X | Environmental Modification | KY | |
N | 225XF0002X | Feeding, Eating & Swallowing | KY | |
N | 225XG0600X | Occupational Therapist - Gerontology | KY | |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | KY | |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | ||
N | 225XP0200X | Occupational Therapist - Pediatrics | KY |
NPI | 1083102685 |
---|---|
Provider Name | Mrs. Andrea M O'brien |
First Address | Louisville, KY 40291-1725 |
Second Address | Louisville, KY 40291-1725 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/04/2018 |
Last Update Date | 13/04/2020 |