Provider Demographics
NPI:1225292345
Name:DAFFRON, KAREN ANN (COTA)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:ANN
Last Name:DAFFRON
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42101-1746
Mailing Address - Country:US
Mailing Address - Phone:270-843-3296
Mailing Address - Fax:
Practice Address - Street 1:550 HIGH ST
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42101-1746
Practice Address - Country:US
Practice Address - Phone:270-843-3296
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-17
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKYA-1566224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant