Individual
AUTUMN BAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1505 BELMAR DR, LOUISVILLE, KY 40213-1705
(503) 803-2912
Mailing address
1505 BELMAR DR, LOUISVILLE, KY 40213-1705
(503) 803-2912
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
BOTOCT00220887
KY
Other
Enumeration date
07/01/2016
Last updated
02/12/2026
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