Provider Demographics
NPI:1093777328
Name:MORGAN, KALEN M (OT)
Entity Type:Individual
Prefix:
First Name:KALEN
Middle Name:M
Last Name:MORGAN
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:KALEN
Other - Middle Name:M
Other - Last Name:KING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:875 PENNSYLVANIA AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:BARDSTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40004-2529
Mailing Address - Country:US
Mailing Address - Phone:502-349-6961
Mailing Address - Fax:502-348-1789
Practice Address - Street 1:875 PENNSYLVANIA AVE
Practice Address - Street 2:SUITE A
Practice Address - City:BARDSTOWN
Practice Address - State:KY
Practice Address - Zip Code:40004-2529
Practice Address - Country:US
Practice Address - Phone:502-349-6961
Practice Address - Fax:502-348-1789
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY135485225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY718419Medicare ID - Type Unspecified