Provider Demographics
NPI:1245438993
Name:BROWN, ELIZABETH CLARE (OTRL)
Entity type:Individual
Prefix:MISS
First Name:ELIZABETH
Middle Name:CLARE
Last Name:BROWN
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 EASTWAY DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-2411
Mailing Address - Country:US
Mailing Address - Phone:859-625-0741
Mailing Address - Fax:
Practice Address - Street 1:130 MEADOWLARK DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-2238
Practice Address - Country:US
Practice Address - Phone:859-623-9472
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR2782225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist