Provider Demographics
NPI:1386043081
Name:OXENDER, TERRI L (OTR/L, ATP)
Entity Type:Individual
Prefix:
First Name:TERRI
Middle Name:L
Last Name:OXENDER
Suffix:
Gender:F
Credentials:OTR/L, ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:845 S 3RD ST
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40203-2213
Mailing Address - Country:US
Mailing Address - Phone:502-873-4213
Mailing Address - Fax:
Practice Address - Street 1:901 S THIRD ST
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40203-2213
Practice Address - Country:US
Practice Address - Phone:502-873-4213
Practice Address - Fax:502-585-7104
Is Sole Proprietor?:No
Enumeration Date:2014-08-19
Last Update Date:2014-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR2551225X00000X, 261QC1500X, 261QR0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health