Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 31004237A | IN |
N | 225XG0600X | Occupational Therapist - Gerontology | 164536 | KY |
N | 225XP0200X | Occupational Therapist - Pediatrics |
NPI | 1093046922 |
---|---|
Provider Name | Mrs. Christi Danielle Mckim |
First Address | Louisville, KY 40206-2544 |
Second Address | Louisville, KY 40299-2392 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/01/2010 |
Last Update Date | 10/09/2018 |