Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 31004536A | IN |
NPI | 1003139601 |
---|---|
Provider Name | Miss Sarah Rains |
First Address | Evansville, IN 47712-2750 |
Second Address | Evansville, IN 47712-2750 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/03/2010 |
Last Update Date | 10/03/2010 |