Healthcare Provider Details

I. General information

NPI: 1548410541
Provider Name (Legal Business Name): ANN LYON BEEBE OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2008
Last Update Date: 07/25/2023
Certification Date: 07/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

732 WELLINGTON WAY
LEXINGTON KY
40503-2736
US

IV. Provider business mailing address

732 WELLINGTON WAY
LEXINGTON KY
40503-2736
US

V. Phone/Fax

Practice location:
  • Phone: 859-552-2126
  • Fax:
Mailing address:
  • Phone: 859-552-2126
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberR3403
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number132042
License Number StateKY
# 3
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: