Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 137207 | KY |
NPI | 1952978512 |
---|---|
Provider Name | Ellen Violand |
First Address | Fort Thomas, KY 41075-2034 |
Second Address | Fort Thomas, KY 41075-2034 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2021 |
Last Update Date | 10/06/2021 |