Laura Goodan-Graham, OT

Individual provider Active NPI Occupational Therapist · Prospect, KY

NPI 1346409505 · NPPES record last updated Jun 3, 2008

Key facts

NPI
1346409505
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
KY-R2787 (KY)
Practice address
6301 Bass Rd
Prospect, KY 40059-9384
Phone
(502) 228-9440
NPI assigned
Jun 3, 2008
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
KY-R2787KYMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X KY-R2787 KY Yes

Addresses

Primary practice location

6301 Bass Rd
Prospect, KY 40059-9384

Mailing address

7620 Woodridge Dr
Pewee Valley, KY 40056-9027
Phone (502) 241-0708

Other providers in Prospect, KY

All providers in Prospect, KY · Occupational Therapist in Kentucky

Sources for this page

Verify at the official NPI Registry.