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Individual

SANDRA JEANNE ALLEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OT

Contact information

Practice address
2700 GREENUP AVE, ASHLAND, KY 41101-1953
(606) 324-0540
(606) 324-0616
Mailing address
2700 GREENUP AVE, ASHLAND, KY 41101-1953
(606) 324-0540
(606) 324-0616

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
134295
KY
225XH1200X
Hand Occupational Therapist
134295
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
R0853
OT LICENSE
KY
Enumeration date
05/14/2020
Last updated
05/14/2020
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