Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 32001947A | IN |
NPI | 1023309168 |
---|---|
Provider Name | Abigail L Merkley |
First Address | Dale, IN 47523-0315 |
Second Address | Dale, IN 47523-8947 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2011 |
Last Update Date | 24/04/2011 |