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General NPI Number Information
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NPI Number | 1730592015
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Entity Type | Individual
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Provider Name | TREVOR ST CLAIR OTR/L
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Gender | Male
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Dates
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Enumeration Date | 06/04/2014
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Last Update Date | 09/24/2024
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Provider Practice Location Address
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Address Line | 9905 FALL CREED ROAD
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City | INDIANAPOLIS
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State | IN
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Zip | 46256
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Country | US
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Telephone | 317-676-4700
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Fax |
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Provider Business Mailing Address
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Address Line | 9905 FALL CREED RD
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City | INDIANAPOLIS
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State | IN
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Zip | 46256
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Country | US
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Telephone | 304-288-2370
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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 | 316029
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License Number State | OR
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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 | 8936
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 31008495A
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License Number State | IN
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