Provider Demographics
NPI:1053397448
Name:HARLAN, PATRICIA JEANENE (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:JEANENE
Last Name:HARLAN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:JENNY
Other - Middle Name:
Other - Last Name:HARLAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTR/L
Mailing Address - Street 1:1048 LEES CHAPEL RD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:KY
Mailing Address - Zip Code:42602
Mailing Address - Country:US
Mailing Address - Phone:606-306-1225
Mailing Address - Fax:317-780-3745
Practice Address - Street 1:1048 LEES CHAPEL RD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:KY
Practice Address - Zip Code:42602
Practice Address - Country:US
Practice Address - Phone:606-306-1225
Practice Address - Fax:317-780-3745
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-19
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR2791225000000X
KYR-2791225000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter