Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 31003400A | IN |
NPI | 1457970089 |
---|---|
Provider Name | Carol A Barnes |
First Address | Indianapolis, IN 46259-6833 |
Second Address | Indianapolis, IN 46259-6833 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2020 |
Last Update Date | 14/04/2020 |