Individual
JILL ELAINE BEATTIE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
100 KY-15, JACKSON, KY 41339
(606) 824-5115
Mailing address
100 KY-15, JACKSON, KY 41339
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
163735
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
163735
KBLOT
KY
Enumeration date
06/08/2020
Last updated
11/27/2023
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