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General NPI Number Information
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NPI Number | 1750808531
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Entity Type | Organization
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Legal Business Name | THERATREE, LLC.
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Dates
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Enumeration Date | 08/23/2017
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Last Update Date | 07/07/2022
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Provider Practice Location Address
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Address Line | 2605 NEW HARTFORD RD
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City | OWENSBORO
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State | KY
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Zip | 42303-1316
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Country | US
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Telephone | 270-688-8449
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Fax | 270-240-4840
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Provider Business Mailing Address
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Address Line | 2605 NEW HARTFORD RD
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City | OWENSBORO
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State | KY
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Zip | 42303-1316
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Country | US
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Telephone | 270-688-8449
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Fax | 270-240-4840
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Authorized Official
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Title or Position | OWNER , CEO
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Name | JESSICA KAITLIN LYNN HATFIELD
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Credential | OTR/L
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Telephone | 270-688-8449
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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