Provider Demographics
NPI:1093017881
Name:MACKEY, RUTH ELAINE (OT)
Entity Type:Individual
Prefix:MRS
First Name:RUTH
Middle Name:ELAINE
Last Name:MACKEY
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:375 N SPALDING AVE
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:KY
Mailing Address - Zip Code:40033-1520
Mailing Address - Country:US
Mailing Address - Phone:270-692-1518
Mailing Address - Fax:
Practice Address - Street 1:375 N SPALDING AVE
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:KY
Practice Address - Zip Code:40033-1520
Practice Address - Country:US
Practice Address - Phone:270-692-1518
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-30
Last Update Date:2010-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR2021225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist