Madison Crim, COTA/L

Individual provider Active NPI Occupational Therapy Assistant · Dawson Springs, KY

NPI 1417529413 · NPPES record last updated May 4, 2023

Key facts

NPI
1417529413
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
269420 (KY)
Practice address
213 Water St
Dawson Springs, KY 42408-1727
Phone
(270) 797-2025
NPI assigned
Jul 11, 2021
Sex
Female
Sole proprietor
Yes

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
269420KYMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 269420 KY Yes

Addresses

Primary practice location

213 Water St
Dawson Springs, KY 42408-1727

Mailing address

100 W Ramsey St
Dawson Springs, KY 42408-1818

Other providers in Dawson Springs, KY

All providers in Dawson Springs, KY · Occupational Therapy Assistant in Kentucky

Sources for this page

Verify at the official NPI Registry.