Provider Demographics
NPI:1568709624
Name:MARCUM, KARA L (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:L
Last Name:MARCUM
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:KARA
Other - Middle Name:L
Other - Last Name:MOON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:24 GORDON LN
Mailing Address - Street 2:
Mailing Address - City:CAMPBELLSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42718-8860
Mailing Address - Country:US
Mailing Address - Phone:270-537-3208
Mailing Address - Fax:
Practice Address - Street 1:102 NANCY COX DR
Practice Address - Street 2:
Practice Address - City:CAMPBELLSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42718-8898
Practice Address - Country:US
Practice Address - Phone:270-465-8508
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-09
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY133920225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist