Individual
MRS. JILL BEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OCCUPATIONAL THERAPY
Contact information
Practice address
1563 WRIGHTS LANDING RD, OWENSBORO, KY 42303-9742
(270) 668-9125
Mailing address
1563 WRIGHTS LANDING RD, OWENSBORO, KY 42303-9742
(270) 668-9125
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11903135ICF
—
KY
05
—
33000035SCL
—
KY
05
—
45118379EPSDT
—
KY
Enumeration date
12/27/2006
Last updated
04/01/2014
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