Provider Demographics
NPI:1366672735
Name:ARNOLD, TAMMY L (MS OTR/L)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:L
Last Name:ARNOLD
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 1:560 DOUGLAS AVE
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40508-1072
Mailing Address - Country:US
Mailing Address - Phone:859-523-5428
Mailing Address - Fax:
Practice Address - Street 1:560 DOUGLAS AVE
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40508-1072
Practice Address - Country:US
Practice Address - Phone:859-523-5428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-20
Last Update Date:2009-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-R2683225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist