Provider Demographics
NPI:1740487701
Name:POOLE, DENISE ANDREA (OTR L)
Entity type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:ANDREA
Last Name:POOLE
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 1:111 STOCKTON CT APT A
Mailing Address - Street 2:
Mailing Address - City:RADCLIFF
Mailing Address - State:KY
Mailing Address - Zip Code:40160-8138
Mailing Address - Country:US
Mailing Address - Phone:270-832-3752
Mailing Address - Fax:
Practice Address - Street 1:101 FAIRGROUNDS RD.
Practice Address - Street 2:
Practice Address - City:HARDINSBURG
Practice Address - State:KY
Practice Address - Zip Code:40143
Practice Address - Country:US
Practice Address - Phone:270-756-2159
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2025-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR3580225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist