MEDICARE: BARBARA P BLAIN 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	225XF0002X	Feeding, Eating & Swallowing Occupational Therapist	31001006 A	IN
2	225XP0200X	Pediatric Occupational Therapist	31001006 A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588967715
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARBARA P BLAIN OTR

Provider Business Mailing Address
First Line	:	8224 MANN RD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46221-9638
Country	:	US
Telephone Number	:	317-442-4734
Fax Number	:	317-791-9001

Provider Business Practice Location Address
First Line	:	6303 S EAST ST
Second Line	:	SUITE B
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46227-7114
Country	:	US
Telephone Number	:	317-791-9031
Fax Number	:	317-791-9001

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

Provider Enumeration Date	:	12/09/2010
Last Update Date	:	12/09/2010

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Directions to “ BARBARA P BLAIN OTR” Practice Location

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