Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | R2858 | KY |
NPI | 1295999035 |
---|---|
Provider Name | Heather Lenore Collett |
First Address | Hyden, KY 41749-1689 |
Second Address | Bledsoe, KY 40810 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2008 |
Last Update Date | 10/07/2008 |