Provider Demographics
NPI:1891503298
Name:HIRN, MALEAH FAITH (OTD)
Entity type:Individual
Prefix:
First Name:MALEAH
Middle Name:FAITH
Last Name:HIRN
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10301 CONEFLOWER LN
Mailing Address - Street 2:
Mailing Address - City:PROSPECT
Mailing Address - State:KY
Mailing Address - Zip Code:40059-8355
Mailing Address - Country:US
Mailing Address - Phone:859-835-3010
Mailing Address - Fax:
Practice Address - Street 1:10301 CONEFLOWER LN
Practice Address - Street 2:
Practice Address - City:PROSPECT
Practice Address - State:KY
Practice Address - Zip Code:40059-8355
Practice Address - Country:US
Practice Address - Phone:502-515-5440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-18
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY288742225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist