Provider Demographics
NPI:1265784136
Name:KERMANSHAHI, BARBARA RAILING (OTR/L)
Entity type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:RAILING
Last Name:KERMANSHAHI
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 1:303 N HURSTBOURNE PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222-5158
Mailing Address - Country:US
Mailing Address - Phone:502-412-5847
Mailing Address - Fax:502-412-5847
Practice Address - Street 1:5528 W MALLARD DR
Practice Address - Street 2:
Practice Address - City:SCOTTSBURG
Practice Address - State:IN
Practice Address - Zip Code:47170-7491
Practice Address - Country:US
Practice Address - Phone:812-752-6699
Practice Address - Fax:812-752-6699
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-03
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31001717A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist