Provider Demographics
NPI:1295219152
Name:LIM, BEVERLY ANN (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:BEVERLY ANN
Middle Name:
Last Name:LIM
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:PO BOX 1376
Mailing Address - Street 2:
Mailing Address - City:HAZARD
Mailing Address - State:KY
Mailing Address - Zip Code:41702-1376
Mailing Address - Country:US
Mailing Address - Phone:606-854-9144
Mailing Address - Fax:
Practice Address - Street 1:52 RAISIN LN
Practice Address - Street 2:
Practice Address - City:HAZARD
Practice Address - State:KY
Practice Address - Zip Code:41701-8390
Practice Address - Country:US
Practice Address - Phone:606-854-9144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-17
Last Update Date:2018-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY133804225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist