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Individual

MRS. TAMMY LYNN COLON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSOTR/L

Contact information

Practice address
1169 EASTERN PKWY, SUITE 2313, LOUISVILLE, KY 40217-1417
(502) 309-9800
(502) 309-9797
Mailing address
PO BOX 3276, EVANSVILLE, IN 47731-3276
(812) 473-0181
(812) 473-5822

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
KY-R3839
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000972248
ANTHEM BCBS
KY
01
132092
LICENSE
KY
01
236445
NATIONAL BOARD FOR CERTIFICATION N OCCUPATIONAL THERAPY INC..
01
31004543A
INDIANA PROFESSIONAL LICENSING AGENCY FOR OCCUPATIONAL THERAPY
IN
05
7100369700
KY
Enumeration date
07/10/2008
Last updated
09/16/2016
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