Individual
MS. TRESA LYNN THELEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT/M.ED
Contact information
Practice address
1518 SAINT CLAIR ST, COVINGTON, KY 41011-2946
(859) 907-4200
Mailing address
1518 ST. CLAIR ST., COVINGTON, KY 41011
(859) 907-4200
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1728
CO
225X00000X
Occupational Therapist
R3280
KY
Other
Enumeration date
03/04/2009
Last updated
03/04/2009
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