Provider Demographics
NPI:1740454289
Name:BASKIN, EMILY J (LMT)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:J
Last Name:BASKIN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1264 ROYAL AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40204-2444
Mailing Address - Country:US
Mailing Address - Phone:502-235-0017
Mailing Address - Fax:
Practice Address - Street 1:9509 US HWY 42
Practice Address - Street 2:SUITE 207
Practice Address - City:PROSPECT
Practice Address - State:KY
Practice Address - Zip Code:40059
Practice Address - Country:US
Practice Address - Phone:502-235-0017
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-16
Last Update Date:2011-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-2286225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist