Provider Demographics
NPI:1528201753
Name:KOPP, AIMEE DIANNE (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:AIMEE
Middle Name:DIANNE
Last Name:KOPP
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MISS
Other - First Name:AIMEE
Other - Middle Name:DIANNE
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14303 FAIRFIELD HILL DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40245-7414
Mailing Address - Country:US
Mailing Address - Phone:502-241-2179
Mailing Address - Fax:
Practice Address - Street 1:711 FRANKFORT RD
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:KY
Practice Address - Zip Code:40065-9447
Practice Address - Country:US
Practice Address - Phone:502-513-1875
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-17
Last Update Date:2009-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-R3189225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation