Individual
VICKI YVONNE BASHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
514 LAKEPOINT VIEW RD, MONTICELLO, KY 42633-4466
(606) 307-8349
Mailing address
514 LAKEPOINT VIEW RD, MONTICELLO, KY 42633-4466
(606) 307-8349
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
R4058
KY
Other
Enumeration date
10/24/2008
Last updated
06/02/2012
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