Individual
JILLIAN STREET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
109 S SPRING ST, LOUISVILLE, KY 40206-1952
(502) 592-5007
Mailing address
109 S SPRING ST, LOUISVILLE, KY 40206-1952
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
A5928
KY
Other
Enumeration date
08/17/2014
Last updated
08/17/2014
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