Teresa L Tomamichel, COTA

Individual provider Active NPI Occupational Therapy Assistant · Cloverdale, IN

NPI 1487908653 · NPPES record last updated Nov 9, 2012

Key facts

NPI
1487908653
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
303222 (IN)
Practice address
34 S Main St
Cloverdale, IN 46120-8531
Phone
(812) 821-2872
NPI assigned
Nov 9, 2012
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
303222INMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 303222 IN Yes

Addresses

Primary practice location

34 S Main St
Cloverdale, IN 46120-8531

Mailing address

2052 Santa Fe LN
Spencer, IN 47460-5615
Phone (812) 821-2872

Other providers in Cloverdale, IN

All providers in Cloverdale, IN · Occupational Therapy Assistant in Indiana

Sources for this page

Verify at the official NPI Registry.