Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 31005735A | IN |
N | 225XH1200X | Occupational Therapist - Hand | 31005735A | IN |
NPI | 1164822730 |
---|---|
Provider Name | Sarah Elizabeth Mart |
First Address | Indianapolis, IN 46260-2046 |
Second Address | Indianapolis, IN 46260-2046 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2014 |
Last Update Date | 27/03/2019 |