Christine Lybb Aragon, OTR
Individual provider Active NPI Occupational Therapist · Mishawaka, IN
NPI 1174700322 · NPPES record last updated Jul 13, 2011
Key facts
- NPI
- 1174700322
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 31001712A (IN)
- Practice address
- 4609 Grape Rd
Suite B7
Mishawaka, IN 46545-2649 - Phone
- (269) 268-5601
- Fax
- (888) 370-2324
- NPI assigned
- Jan 29, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130808000110 | IN | Practitioner - Occupational Therapist in Private Practice | 9032363379 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31001712A | IN | MD | Occupational Therapist |
| 5201006523 | MI | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Powerback Rehabilitation LLC | Occupational Therapist | Current |
Accepting new patients |
| Powerback Rehabilitation LLC | Occupational Therapist | Current |
Accepting new patients |
Locations
611 W County Line Rd S
Fort Wayne, IN 46814
Phone (260) 625-1445
101 E State St
Kennett Square, PA 19348
Phone (610) 925-4436
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 5201006523 | MI | |
| Occupational Therapist | 225X00000X | 31001712A | IN | Yes |
Addresses
Primary practice location
4609 Grape Rd
Suite B7
Mishawaka, IN 46545-2649
Mailing address
4609 Grape Rd
Suite B7
Mishawaka, IN 46545-2649
Phone (269) 268-5601
Other providers in Mishawaka, IN
- Bilal Ansari
- Muhammad Shahzad Mumtaz Ansari
- Ophelia Ansari
- Rafat H Ansari
- Apex Healthcare Group PC
- Muhammad S. Arain
- Arcadia Healthcare Solutions, Inc.
- Christopher Armentrout
- Maranda Emily Armstead
- Brandi Arredondo
All providers in Mishawaka, IN · Occupational Therapist in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.