Individual
BRADLEY DON MOULDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
8203 THORNWOOD RD, LOUISVILLE, KY 40220-2887
(502) 552-6648
Mailing address
8203 THORNWOOD RD, LOUISVILLE, KY 40220-2887
(502) 552-6648
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
132380
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
132380
OCCUPATIONAL THERAPIST LICENSE
KY
01
—
31001444A
OCCUPATIONAL THERAPIST LICENSE
IN
Enumeration date
10/01/2021
Last updated
10/01/2021
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