Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 31004810A | IN |
NPI | 1396078614 |
---|---|
Provider Name | Erica Jones |
First Address | Evansville, IN 47725-9796 |
Second Address | Evansville, IN 47725-9796 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/09/2009 |
Last Update Date | 06/10/2020 |