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General NPI Number Information
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NPI Number | 1538854955
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Entity Type | Individual
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Provider Name | COURTNEY BRECHIN VINCENT OTR/L
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Gender | Female
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Dates
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Enumeration Date | 04/11/2023
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Last Update Date | 04/11/2023
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Provider Practice Location Address
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Address Line | 635 S MAIN ST
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City | LEITCHFIELD
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State | KY
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Zip | 42754-1056
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Country | US
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Telephone | 270-287-0656
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Fax |
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Provider Business Mailing Address
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Address Line | 128 CROW HOLLOW RD
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City | CLARKSON
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State | KY
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Zip | 42726-8107
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Country | US
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Telephone | 270-589-3546
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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 | 284621
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License Number State | KY
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