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General NPI Number Information
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NPI Number | 1043538119
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Entity Type | Individual
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Provider Name | CAROL YVONNE FRISBY OT
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Gender | Female
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Dates
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Enumeration Date | 05/13/2010
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Last Update Date | 12/19/2019
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Provider Practice Location Address
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Address Line | 5633 NEWHALL PL
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City | INDIANAPOLIS
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State | IN
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Zip | 46239-8949
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Country | US
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Telephone | 317-366-4265
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 17901
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City | INDIANAPOLIS
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State | IN
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Zip | 46217-0901
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Country | US
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Telephone | 463-212-4227
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 31004409A
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License Number State | IN
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