Provider Demographics
NPI:1760527477
Name:OCCUPATIONAL THERAPY INTERVENTIONS, INC.
Entity Type:Organization
Organization Name:OCCUPATIONAL THERAPY INTERVENTIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:MARCUM
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:606-598-4667
Mailing Address - Street 1:155 MIZE BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:KY
Mailing Address - Zip Code:40962-6632
Mailing Address - Country:US
Mailing Address - Phone:606-598-4667
Mailing Address - Fax:606-598-4667
Practice Address - Street 1:155 MIZE BRANCH RD
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:KY
Practice Address - Zip Code:40962-6632
Practice Address - Country:US
Practice Address - Phone:606-598-4667
Practice Address - Fax:606-598-4667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-R1597174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty