Individual
MRS. JENNY MUDD NEEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSOT, OTR/L
Contact information
Practice address
704 BLOOMFIELD RD, BARDSTOWN, KY 40004-2025
(502) 331-5478
(502) 348-9825
Mailing address
120 TRINITY CEMETERY LOOP, BARDSTOWN, KY 40004-7914
(502) 348-5798
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
KY-R3653
KY
225XP0200X
Pediatric Occupational Therapist
Primary
134493
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001039542
ANTHEM
KY
01
—
50116374
PASSPORT HEALTH
KY
05
—
7100424370
—
KY
Enumeration date
07/20/2007
Last updated
01/12/2017
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