MEDICARE: JAYE ALLEN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	243344	KY
2	225X00000X	Occupational Therapist	119300	TX

General Provider Information

NPI Number	:	1841770005
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAYE ALLEN

Provider Business Mailing Address
First Line	:	8205 ARBOR MEADOW WAY
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40228-4415
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8205 ARBOR MEADOW WAY
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40228-4415
Country	:	US
Telephone Number	:	502-608-4353
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2018
Last Update Date	:	08/17/2018

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Directions to “ JAYE ALLEN ” Practice Location

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