Individual
CASEY HUMPHREY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MHA, OTR/L, CBIS
Contact information
Practice address
103 WINDSOR PATH, SUITE 4, GEORGETOWN, KY 40324
(502) 863-3870
Mailing address
103 WINDSOR PATH, SUITE 4, GEORGETOWN, KY 40324
(502) 863-3870
Taxonomy
Speciality
Code
Description
License number
State
225XN1300X
Neurorehabilitation Occupational Therapist
Primary
KY-R3554
KY
Other
Enumeration date
12/28/2015
Last updated
12/28/2015
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