Healthcare Provider Details

I. General information

NPI: 1417878729
Provider Name (Legal Business Name): CARI JO CUMBERWORTH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 E VAN TREES ST
WASHINGTON IN
47501-2948
US

IV. Provider business mailing address

13901 N 1025 E
ODON IN
47562-5587
US

V. Phone/Fax

Practice location:
  • Phone: 812-254-2673
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number31006967A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: