Provider Demographics
NPI:1356464580
Name:HEBERT, ARLENE L (OTRL)
Entity Type:Individual
Prefix:
First Name:ARLENE
Middle Name:L
Last Name:HEBERT
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12608 KIRKHAM RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40299-4664
Mailing Address - Country:US
Mailing Address - Phone:502-245-3829
Mailing Address - Fax:502-245-3829
Practice Address - Street 1:12608 KIRKHAM RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40299-4664
Practice Address - Country:US
Practice Address - Phone:502-245-3829
Practice Address - Fax:502-245-3829
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR0637225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics