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General NPI Number Information
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NPI Number | 1356945372
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Entity Type | Individual
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Provider Name | CAROLINE THOMSON
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Gender | Female
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Dates
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Enumeration Date | 11/30/2020
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Last Update Date | 11/30/2020
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Provider Practice Location Address
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Address Line | 802 N SAMUEL MOORE PKWY
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City | MOORESVILLE
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State | IN
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Zip | 46158-1467
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Country | US
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Telephone | 317-834-0200
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Fax |
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Provider Business Mailing Address
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Address Line | 7884 CREEK RIDGE DR
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City | BROWNSBURG
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State | IN
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Zip | 46112-8214
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Country | US
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Telephone | 317-989-7238
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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 | 32003513A
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License Number State | IN
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