Individual
MADELINE GRACE LANHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
15 AUDUBON PLAZA DR, LOUISVILLE, KY 40217-1371
(502) 636-2300
Mailing address
100 BRENTFORD DR, LOUISVILLE, KY 40245-7010
(502) 974-3221
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
459460
KY
Other
Enumeration date
08/21/2021
Last updated
08/21/2021
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