Provider Demographics
NPI:1780822924
Name:FARRELL, KAPI DISMUKES (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:KAPI
Middle Name:DISMUKES
Last Name:FARRELL
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 1:911 SHADES RD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-5215
Mailing Address - Country:US
Mailing Address - Phone:205-585-8485
Mailing Address - Fax:
Practice Address - Street 1:3057 LORNA RD STE 220
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35216-4518
Practice Address - Country:US
Practice Address - Phone:205-585-8485
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-26
Last Update Date:2009-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2372225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics