Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | R3578 | KY |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | R3578 | KY |
NPI | 1124219803 |
---|---|
Provider Name | Mrs. Marsha Dawn Spain |
First Address | Hopkinsville, KY 42240-1146 |
Second Address | Cadiz, KY 42211-9605 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2007 |
Last Update Date | 07/08/2007 |