Basic Information
| Provider Information | |||||||||
| NPI: | 1306203864 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STAPLES | ||||||||
| FirstName: | EMILY | ||||||||
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| Credential: | MS, OTR/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 902 LINGALE DR | ||||||||
| Address2: | |||||||||
| City: | CAVE CITY | ||||||||
| State: | KY | ||||||||
| PostalCode: | 421278421 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2704045085 | ||||||||
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| Practice Location | |||||||||
| Address1: | 300 WESTWOOD ST | ||||||||
| Address2: | |||||||||
| City: | GLASGOW | ||||||||
| State: | KY | ||||||||
| PostalCode: | 421411030 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2706519131 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/27/2016 | ||||||||
| LastUpdateDate: | 01/27/2016 | ||||||||
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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 | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.