Provider Demographics
NPI:1518237064
Name:COX, DEIRDRE PAULINE (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:DEIRDRE
Middle Name:PAULINE
Last Name:COX
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2022 PARKLAND DR
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42503-2717
Mailing Address - Country:US
Mailing Address - Phone:646-675-3200
Mailing Address - Fax:606-653-1861
Practice Address - Street 1:2022 PARKLAND DR
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-2717
Practice Address - Country:US
Practice Address - Phone:646-675-3200
Practice Address - Fax:606-653-1861
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-30
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY166491225X00000X
OH007892225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist