Provider Demographics
NPI:1477716694
Name:DANIELS, ELAINE RITA (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:ELAINE
Middle Name:RITA
Last Name:DANIELS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:ELAINE
Other - Middle Name:RITA
Other - Last Name:LAGEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:10700 FREMONT DR
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41051-9075
Mailing Address - Country:US
Mailing Address - Phone:859-750-8620
Mailing Address - Fax:
Practice Address - Street 1:10700 FREMONT DR
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:KY
Practice Address - Zip Code:41051-9075
Practice Address - Country:US
Practice Address - Phone:859-750-8620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-08
Last Update Date:2013-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR3923225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist