Individual
WINNIE L TARTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
616 DRUMMOND WAY, FAIRDALE, KY 40118-9632
(502) 492-9452
Mailing address
616 DRUMMOND WAY, FAIRDALE, KY 40118-9632
(502) 414-1707
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
161877
KY
Other
Enumeration date
11/04/2017
Last updated
11/04/2017
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