Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 31006956A | IN |
NPI | 1003461898 |
---|---|
Provider Name | Erika Prescott |
First Address | New Albany, IN 47150-9473 |
Second Address | New Albany, IN 47150-9473 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2019 |
Last Update Date | 07/08/2019 |