Healthcare Provider Details

I. General information

NPI: 1750925327
Provider Name (Legal Business Name): BARBARA JEAN CARY OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BARBARA J MONROE OTR

II. Dates (important events)

Enumeration Date: 11/06/2019
Last Update Date: 11/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 N MAIN ST
AVILLA IN
46710-9601
US

IV. Provider business mailing address

530 BAYVIEW DR
ROME CITY IN
46784-9710
US

V. Phone/Fax

Practice location:
  • Phone: 260-897-2841
  • Fax: 260-897-2848
Mailing address:
  • Phone: 260-502-1446
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number31001103A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code225XG0600X
TaxonomyGerontology Occupational Therapist
License Number31001103A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: