Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | KY-A2497 | KY |
NPI | 1972719326 |
---|---|
Provider Name | Ms. Rebecca Lorraine Hafford |
First Address | Eldorado, IL 62930 |
Second Address | Lacenter, KY 42056-0269 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2007 |
Last Update Date | 08/07/2007 |