Provider Demographics
NPI:1275979569
Name:PADGETT, DANA MARIE (OTR/L)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:MARIE
Last Name:PADGETT
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 1:1205 WOODLAND DR
Mailing Address - Street 2:SUITE B100
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-2709
Mailing Address - Country:US
Mailing Address - Phone:270-766-1055
Mailing Address - Fax:270-766-1056
Practice Address - Street 1:1205 WOODLAND DR
Practice Address - Street 2:SUITE B100
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-2709
Practice Address - Country:US
Practice Address - Phone:270-766-1055
Practice Address - Fax:270-766-1056
Is Sole Proprietor?:No
Enumeration Date:2013-05-14
Last Update Date:2014-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-R2789225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist