Individual
HALEY BRUCKNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
308 W MAPLE AVE, LANCASTER, KY 40444-1005
(859) 752-6844
Mailing address
211 TERRACE CT, DANVILLE, KY 40422-1621
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
440747
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
267243
KENTUCKY OCCUPATIONAL THERAPY LICENSE
KY
Enumeration date
11/28/2020
Last updated
12/07/2020
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