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General NPI Number Information
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NPI Number | 1871006130
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Entity Type | Individual
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Provider Name | KAITLIN HANCOCK UPTON MS, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 11/08/2017
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | 8225 WHIPPS MILL RD
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City | LOUISVILLE
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State | KY
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Zip | 40222-5482
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Country | US
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Telephone | 775-367-6937
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Fax |
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Provider Business Mailing Address
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Address Line | 1379 PLAYERS CLUB CIR
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City | GULF BREEZE
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State | FL
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Zip | 32563-3521
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Country | US
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Telephone | 775-367-6937
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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 | 266639
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License Number State | KY
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