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Individual

FLENCE LYKA DURAN MACOPIA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTRL

Contact information

Practice address
260 HOSPITAL DR, SOUTH WILLIAMSON, KY 41503-4072
(606) 237-1717
Mailing address
20325 YOUNGSTOUN CT APT 2704, HAGERSTOWN, MD 21742-8217
(304) 785-9941

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
09623
MD
225X00000X
Occupational Therapist
164274
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
164274
KENTUCKY BOARD OF LICENSURE FOR OCCUPATIONAL THERAPY
KY
Enumeration date
07/16/2019
Last updated
09/18/2022
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