Individual
CORENA LYNN DUCKWALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4603 TIMBERWALK CT, LA GRANGE, KY 40031-6746
(703) 864-6695
Mailing address
4604 TIMBERWALK CT, LA GRANGE, KY 40031-6746
(703) 864-6695
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
161459
KY
Other
Enumeration date
11/01/2021
Last updated
11/01/2021
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