MEDICARE: MS. MAUREEN JOAN O'BRIEN OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225XN1300X	Neurorehabilitation Occupational Therapist	133238	KY

General Provider Information

NPI Number	:	1639144827
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MAUREEN JOAN O'BRIEN OTR/L

Provider Business Mailing Address
First Line	:	200 BRULE ST BLDG 8712158
Second Line	:
City	:	FORT KNOX
State	:	KY
Zip	:	40121-6100
Country	:	US
Telephone Number	:	502-626-9786
Fax Number	:	502-626-9958

Provider Business Practice Location Address
First Line	:	200 BRULE ST BLDG 8712158
Second Line	:
City	:	FORT KNOX
State	:	KY
Zip	:	40121-6100
Country	:	US
Telephone Number	:	502-626-9786
Fax Number	:	502-626-9958

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/21/2006
Last Update Date	:	03/31/2025

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