Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 31003598A | IN |
N | 225XH1200X | Occupational Therapist - Hand | 31003598A | IN |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 31003598A | IN |
NPI | 1184925638 |
---|---|
Provider Name | Elaine M. Stenslik |
First Address | Bolingbrook, IL 60440-4909 |
Second Address | Valparaiso, IN 46383-4484 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2010 |
Last Update Date | 08/06/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P01347900 | RAILROAD MEDICARE (01) | IN |