Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 161460 | KY |
NPI | 1083265441 |
---|---|
Provider Name | Megan M Graham |
First Address | New Castle, KY 40050-6745 |
Second Address | New Castle, KY 40050-6745 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2019 |
Last Update Date | 26/09/2019 |