Provider Demographics
NPI:1306203864
Name:STAPLES, EMILY (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:STAPLES
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:902 LINGALE DR
Mailing Address - Street 2:
Mailing Address - City:CAVE CITY
Mailing Address - State:KY
Mailing Address - Zip Code:42127-8421
Mailing Address - Country:US
Mailing Address - Phone:270-404-5085
Mailing Address - Fax:
Practice Address - Street 1:300 WESTWOOD ST
Practice Address - Street 2:
Practice Address - City:GLASGOW
Practice Address - State:KY
Practice Address - Zip Code:42141-1030
Practice Address - Country:US
Practice Address - Phone:270-651-9131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-27
Last Update Date:2016-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist