Individual
TAMMY M BAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
982 EASTERN PARKWAY, LOUISVILLE, KY 40217-1501
(502) 635-6397
(502) 635-1147
Mailing address
9601 GUTENBERG RD, LOUISVILLE, KY 40299
(502) 240-6237
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
KYR2509
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000188456
ANTHEM
—
Enumeration date
11/03/2006
Last updated
07/08/2007
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