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General NPI Number Information
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NPI Number | 1831313030
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Entity Type | Individual
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Provider Name | MARY TERESE ARNOLD
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Gender | Female
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 661 N MEADOW LARK LN
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City | BLOOMINGTON
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State | IN
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Zip | 47408-2731
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Country | US
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Telephone | 812-327-1887
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Fax |
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Provider Business Mailing Address
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Address Line | 661 N MEADOW LARK LN
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City | BLOOMINGTON
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State | IN
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Zip | 47408-2731
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Country | US
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Telephone | 812-334-3540
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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 | 31001121A
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License Number State | IN
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