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General NPI Number Information
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NPI Number | 1245993203
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Entity Type | Individual
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Provider Name | ALAINA LYNN BOOMERSHINE OTR
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Gender | Female
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Dates
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Enumeration Date | 10/18/2021
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Last Update Date | 07/22/2025
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Provider Practice Location Address
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Address Line | 1176 N MAIN ST
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City | FRANKLIN
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State | IN
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Zip | 46131-1251
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Country | US
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Telephone | 270-731-7343
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Fax |
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Provider Business Mailing Address
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Address Line | 5850 TART BLVD
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City | INDIANAPOLIS
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State | IN
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Zip | 46239-1874
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Country | US
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Telephone | 317-445-4895
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 32003504A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 31008711A
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License Number State | IN
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