Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | T4265 | KY |
NPI | 1003148834 |
---|---|
Provider Name | Rebecca Thomas |
First Address | Bedford, KY 40006-8642 |
Second Address | Bedford, KY 40006-8642 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/02/2010 |
Last Update Date | 04/02/2010 |