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Contact Information

MARSHALL PEDIATRIC THERAPY, LLC
109 WIND HAVEN DR STE 100
NICHOLASVILLE, KY40356-8010
 Phone: 859-224-2273
 Fax: 859-224-4675
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

225XP0200X 67 Occupational Therapist in Private Practice
 

Community/Behavioral Health

251S00000X
 

Occupational Therapist

225X00000X 67 Occupational Therapist in Private Practice
 

Physical Rehabilitation

225XP0019X 67 Occupational Therapist in Private Practice
 

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
 

Professional

101YP2500X
 

Speech-Language Pathologist

235Z00000X 15 Speech Language Pathologist
Indicates primary specialty

NPI Profile & details for MARSHALL PEDIATRIC THERAPY LLC · (Female)

NPI # 1104198472
Status Active
Credentials
Entity Individual
Enumeration date 02/02/2012
Last updated 02/25/2025 - More than a year ago
Sole proprietor 1 Not specified
Identifiers
  • KY License # 1196
  • KY License # 4077
  • KY License # 5326
  • KY License # R3083
  • KY Medicaid 7100205670
  • KY Medicaid 7100215800
  • KY Medicaid 7100275720
  • KY Medicaid 7100278210
  • KY Medicaid 7100299670
  • KY Medicaid 7100328480
  • KY Medicaid 7101016200
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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