Individual
KARA S VONDERHEIDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
982 EASTERN PKWY, LOUISVILLE, KY 40217-1501
(502) 635-6397
(502) 635-1147
Mailing address
3914 BENJE WAY, LOUISVILLE, KY 40241
(502) 425-4646
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
KYR1782
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000201369
ANTHEM
—
05
—
2002340310
—
IN
Enumeration date
11/03/2006
Last updated
07/08/2007
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