Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 31007374A | IN |
N | 225XP0200X | Occupational Therapist - Pediatrics | 8749 | NC |
NPI | 1033629977 |
---|---|
Provider Name | Mary Hart Macleod |
First Address | Indianapolis, IN 46219-4959 |
Second Address | Durham, NC 27705-4504 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2017 |
Last Update Date | 10/01/2022 |