Provider Demographics
NPI:1326883620
Name:TRI-STATE OCCUPATIONAL THERAPY
Entity type:Organization
Organization Name:TRI-STATE OCCUPATIONAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:HUTCHINSON
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:270-827-4857
Mailing Address - Street 1:2003 STAPP DR UNIT C
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:KY
Mailing Address - Zip Code:42420-1601
Mailing Address - Country:US
Mailing Address - Phone:270-827-4857
Mailing Address - Fax:270-827-9773
Practice Address - Street 1:2003 STAPP DR UNIT C
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:KY
Practice Address - Zip Code:42420-1601
Practice Address - Country:US
Practice Address - Phone:270-827-4857
Practice Address - Fax:270-827-9773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-27
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty