Individual
JENA RAE BALLARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
529 WESTPORT RD, ELIZABETHTOWN, KY 42701-2923
(270) 763-8225
Mailing address
289 WILSON CREEK RD, COXS CREEK, KY 40013-7577
(502) 827-3836
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
A5423
KY
Other
Enumeration date
04/16/2013
Last updated
06/04/2019
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