MEDICARE: MS. FIONA KARIN ALLEN BHSC (HONS) OT, OTR

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	31005041A	IN
2	225X00000X	Occupational Therapist	R4539	KY

General Provider Information

NPI Number	:	1528378080
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. FIONA KARIN ALLEN BHSC (HONS) OT, OTR

Provider Business Mailing Address
First Line	:	621 W COLUMBIA ST
Second Line	:
City	:	EVANSVILLE
State	:	IN
Zip	:	47710-1619
Country	:	US
Telephone Number	:	812-428-5678
Fax Number	:

Provider Business Practice Location Address
First Line	:	621 W COLUMBIA ST
Second Line	:
City	:	EVANSVILLE
State	:	IN
Zip	:	47710-1619
Country	:	US
Telephone Number	:	812-428-5678
Fax Number	:

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

Provider Enumeration Date	:	10/18/2010
Last Update Date	:	10/18/2010

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