Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 31001103A | IN |
N | 225XG0600X | Occupational Therapist - Gerontology | 31001103A | IN |
NPI | 1750925327 |
---|---|
Provider Name | Barbara Jean Cary |
First Address | Rome City, IN 46784-9710 |
Second Address | Avilla, IN 46710-9601 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/11/2019 |
Last Update Date | 06/11/2019 |