Leslie Mischelle Birge, COTA/L

Individual provider Active NPI Occupational Therapy Assistant · Glasgow, KY

NPI 1992992499 · NPPES record last updated Sep 27, 2007

Key facts

NPI
1992992499
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
KY-A3119 (KY)
Practice address
113 Millersburg Branch Rd
Glasgow, KY 42141-8877
Phone
(270) 646-3307
NPI assigned
Sep 27, 2007
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
KY-A3119KYMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X KY-A3119 KY Yes

Addresses

Primary practice location

113 Millersburg Branch Rd
Glasgow, KY 42141-8877

Mailing address

113 Millersburg Branch Rd
Glasgow, KY 42141-8877
Phone (270) 646-3307

Other providers in Glasgow, KY

All providers in Glasgow, KY · Occupational Therapy Assistant in Kentucky

Sources for this page

Verify at the official NPI Registry.