Individual
KAYLA RENEE CHEATHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
13010 EASTGATE PARK WAY STE 101, LOUISVILLE, KY 40223-3984
(502) 244-1210
Mailing address
377 RYAN PATRICK DR, SHEPHERDSVILLE, KY 40165-8308
(502) 905-8055
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
132566
KY
225X00000X
Occupational Therapist
R5903
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100341720
—
KY
Enumeration date
11/17/2014
Last updated
04/13/2022
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