Healthcare Provider Details

I. General information

NPI: 1750247961
Provider Name (Legal Business Name): AJ CORE THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/31/2025
Last Update Date: 12/31/2025
Certification Date: 12/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 RICHMOND ST
MOUNT VERNON KY
40456-2709
US

IV. Provider business mailing address

PO BOX 11
MOUNT VERNON KY
40456-0011
US

V. Phone/Fax

Practice location:
  • Phone: 606-256-3332
  • Fax: 606-256-3334
Mailing address:
  • Phone: 606-256-3332
  • Fax: 606-256-3334

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: APRIL L BUSSELL
Title or Position: OWNER/OCCUPATIONAL THERAPIST
Credential: OTR/L
Phone: 606-256-3332