Provider Demographics
NPI:1538941745
Name:CADWELL, EMILY GRACE (OTR/L)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:GRACE
Last Name:CADWELL
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 1:231 QUAIL RUN DR
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42001-8634
Mailing Address - Country:US
Mailing Address - Phone:270-564-7107
Mailing Address - Fax:
Practice Address - Street 1:55 HEATHER LN
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:KY
Practice Address - Zip Code:42025-7529
Practice Address - Country:US
Practice Address - Phone:270-564-7107
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY288627225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist