Basic Information
| Provider Information | |||||||||
| NPI: | 1144693417 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ALVARADO | ||||||||
| FirstName: | DAWN | ||||||||
| MiddleName: | MARIE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | OTR/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 125 STERLING WAY | ||||||||
| Address2: | |||||||||
| City: | MOUNT STERLING | ||||||||
| State: | KY | ||||||||
| PostalCode: | 403531172 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8594983343 | ||||||||
| FaxNumber: | 8594989769 | ||||||||
| Practice Location | |||||||||
| Address1: | 125 STERLING WAY | ||||||||
| Address2: | |||||||||
| City: | MOUNT STERLING | ||||||||
| State: | KY | ||||||||
| PostalCode: | 403531172 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8594983343 | ||||||||
| FaxNumber: | 8594989769 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/08/2015 | ||||||||
| LastUpdateDate: | 11/08/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | RO999 | KY | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.