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NPI 1699261594

NPI 1699261594 : PATRICIA A HOLMES OTR, MOT : INDIANAPOLIS, IN

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General NPI Number Information
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    NPI Number           |    1699261594
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    Entity Type          |    Individual 
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    Provider Name        |    PATRICIA A HOLMES OTR, MOT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/03/2018
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    Last Update Date     |    07/03/2018
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Provider Practice Location Address
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    Address Line         |    1380 E COUNTY LINE RD 
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    City                 |    INDIANAPOLIS
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    State                |    IN
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    Zip                  |    46227-0962
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    Country              |    US
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    Telephone            |    317-885-7050
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    118 MEDICAL DR 
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    City                 |    CARMEL
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    State                |    IN
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    Zip                  |    46032-3323
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    Country              |    US
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    Telephone            |    
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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       |    31005826A
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    License Number State |    IN
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