Victoria Jean Mabanta, OT

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

31002307A Issued in IN

Practice address

6011 E Hanna Ave Ste M
Indianapolis, IN 46203-7115

Phone

(317) 787-3375

Fax

(317) 787-3376

NPI assigned

Dec 21, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Victoria Jean Delaney Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1265596241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1207 MORNINGSIDE DR",
            "city": "LEBANON",
            "state": "IN",
            "postal_code": "460521963",
            "telephone_number": "765-482-6997",
            "fax_number": "317-881-3421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6011 E HANNA AVE STE M",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462037115",
            "telephone_number": "317-787-3375",
            "fax_number": "317-787-3376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MABANTA",
        "first_name": "VICTORIA",
        "middle_name": "JEAN",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-21",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "IN",
            "license": "31002307A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11643050",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VICTORIA",
            "last_name": "DELANEY",
            "middle_name": "JEAN",
            "credential": "OT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mohammed Maalem
• Daniel Maassel
• Benjamin Thomas Maatman, M.D.
• Thomas Korte Maatman, M.D.
• Sinikweyinkosi Mabandla, NURSE PRACTITIONER
• Michelle Mabis, NP
• Christopher L. Mabrey, MS, CM
• Margaret Rose Macbeth, MD
• Alexandria Macdonald
• Krystena L Macdonald, LMHC, MA, QMHP

• Pediatric Occupational Therapist in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Pediatric Occupational Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.