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General NPI Number Information
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NPI Number | 1164982500
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Entity Type | Individual
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Provider Name | EMILY GREENWELL OTR/L
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Gender | Female
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Dates
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Enumeration Date | 03/21/2019
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Last Update Date | 03/21/2019
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Provider Practice Location Address
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Address Line | 946 GOSS AVE APT 5101
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City | LOUISVILLE
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State | KY
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Zip | 40217-2284
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Country | US
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Telephone | 502-797-8269
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Fax |
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Provider Business Mailing Address
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Address Line | 2400 KINGS CROSS CT
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City | LOUISVILLE
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State | KY
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Zip | 40272-2418
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 174476
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License Number State | KY
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