Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 3100218A | IN |
NPI | 1417088758 |
---|---|
Provider Name | Mrs. Lisa Shepherd Pearcy |
First Address | Indianapolis, IN 46256-3499 |
Second Address | Indianapolis, IN 46268-5900 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2007 |
Last Update Date | 08/07/2007 |