Provider Demographics
NPI:1114428588
Name:REEVES, EMILY N (OTR/L)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:N
Last Name:REEVES
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3055 PIMLICO PKWY
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40515-5450
Mailing Address - Country:US
Mailing Address - Phone:859-693-3659
Mailing Address - Fax:
Practice Address - Street 1:100 SPARKS AVE
Practice Address - Street 2:
Practice Address - City:NICHOLASVILLE
Practice Address - State:KY
Practice Address - Zip Code:40356-1004
Practice Address - Country:US
Practice Address - Phone:859-885-4171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-21
Last Update Date:2018-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY171993225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist