Organization
TRACI PURVIS DBA THERAPY BUILDERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACI LYNN PURVIS OTR/L (OCCUPATIONAL THERAPIST)
(502) 302-9024
Entity
Organization
Contact information
Practice address
4211 SHERMAN AVE, LOUISVILLE, KY 40213-1846
(502) 302-9024
(502) 470-7318
Mailing address
4211 SHERMAN AVE, LOUISVILLE, KY 40213-1846
(502) 302-9024
(502) 470-7318
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
KY-R2744
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1134324114
—
KY
01
—
12084937
CAQH
KY
01
—
1362
FIRST STEPS CABINET FOR HEALTH AND FAMILY SERVICES PROVIDER NUMBER
KY
01
—
KY-R2744
KENTUCKY BOARD OF LICENSURE FOR OCCUPATIONAL THERAPY
KY
Enumeration date
07/05/2016
Last updated
07/05/2016
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