Individual
JEN J LI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
4019 MAMARONECK RD, LOUISVILLE, KY 40218-4742
(631) 681-7288
Mailing address
11802 BRINLEY AVE, LOUISVILLE, KY 40243-1089
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
168485
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
168485
KENTUCKY BOARD OF LICENSURE FOR OCCUPATIONAL THERAPY
KY
Enumeration date
12/05/2010
Last updated
05/08/2017
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