Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 224Z00000X | Occupational Therapy Assistant | 169106 | KY |
Y | 224Z00000X | Occupational Therapy Assistant | OTA.005918 | OH |
NPI | 1013425198 |
---|---|
Provider Name | Mrs. Brooke Patterson |
First Address | Burlington, KY 41005-9279 |
Second Address | Cincinnati, OH 45236-6119 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2018 |
Last Update Date | 11/01/2018 |