MEDICARE: ELIZABETH HOPE WHITLOW OTR, MOT, CNT, NTMTC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	31006054A	IN
2	225XF0002X	Feeding, Eating & Swallowing Occupational Therapist	31006054A	IN
3	225XP0200X	Pediatric Occupational Therapist	31006054A	IN

General Provider Information

NPI Number	:	1023824224
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH HOPE WHITLOW OTR, MOT, CNT, NTMTC

Provider Business Mailing Address
First Line	:	6811 SHOALS WAY
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46237-8107
Country	:	US
Telephone Number	:	765-623-2129
Fax Number	:

Provider Business Practice Location Address
First Line	:	6811 SHOALS WAY
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46237-8107
Country	:	US
Telephone Number	:	765-623-2129
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/04/2024
Last Update Date	:	12/04/2024

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