Provider Demographics
NPI:1528345006
Name:HAMM, MARY CARLEEN (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:CARLEEN
Last Name:HAMM
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MISS
Other - First Name:MARY
Other - Middle Name:CARLEEN
Other - Last Name:BARKOCY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:824 E EUCLID AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40502-1785
Mailing Address - Country:US
Mailing Address - Phone:859-335-1100
Mailing Address - Fax:859-335-1106
Practice Address - Street 1:824 E EUCLID AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40502-1785
Practice Address - Country:US
Practice Address - Phone:859-335-1100
Practice Address - Fax:859-335-1106
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-10
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR5007225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist