Paula Kay Maxwell, OTR/L

Individual provider Active NPI Occupational Therapist · Mount Carroll, IL

NPI 1104006907 · NPPES record last updated May 25, 2016

Key facts

NPI
1104006907
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
056.007582 (IL)
Practice address
1006 N Lowden Rd
Mount Carroll, IL 61053-9476
Phone
(815) 244-7715
NPI assigned
Nov 8, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
056.007582ILMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 056.007582 IL Yes

Addresses

Primary practice location

1006 N Lowden Rd
Mount Carroll, IL 61053-9476

Mailing address

1006 N Lowden Rd
Mount Carroll, IL 61053-9476
Phone (815) 244-7715

Other providers in Mount Carroll, IL

All providers in Mount Carroll, IL · Occupational Therapist in Illinois

Sources for this page

Verify at the official NPI Registry.