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NPI 1437350352

NPI 1437350352 : GINA ANNETTE FLORA OTR/L : EWING, KY

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General NPI Number Information
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    NPI Number           |    1437350352
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    Entity Type          |    Individual 
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    Provider Name        |    GINA ANNETTE FLORA OTR/L
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/29/2007
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    Last Update Date     |    11/06/2014
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Provider Practice Location Address
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    Address Line         |    5444 HILLTOP RD. 
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    City                 |    EWING
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    State                |    KY
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    Zip                  |    41039
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    Country              |    US
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    Telephone            |    606-782-5166
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    Fax                  |    606-267-4858
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Provider Business Mailing Address
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    Address Line         |    5444 HILLTOP RD. 
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    City                 |    EWING
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    State                |    KY
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    Zip                  |    41039
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    Country              |    US
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    Telephone            |    606-782-5166
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    Fax                  |    606-267-4858
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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       |    R3110
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    License Number State |    KY
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