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General NPI Number Information
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NPI Number | 1518366525
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Entity Type | Individual
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Provider Name | TABETHA FROST OT
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Gender | Female
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Dates
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Enumeration Date | 08/14/2014
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Last Update Date | 12/13/2019
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Provider Practice Location Address
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Address Line | 401 LEWIS HARGETT CIR STE 120
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City | LEXINGTON
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State | KY
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Zip | 40503-3564
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Country | US
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Telephone | 859-475-4305
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Fax |
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Provider Business Mailing Address
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Address Line | 128 ABBEY RD
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City | VERSAILLES
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State | KY
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Zip | 40383-8044
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | OT.007563
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 133803
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License Number State | KY
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