Tara Lynn McDaniel, COTA

Individual provider Active NPI Occupational Therapy Assistant · La Fontaine, IN

NPI 1891963252 · NPPES record last updated Feb 19, 2008

Key facts

NPI
1891963252
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
32001447A (IN)
Practice address
604 Rennaker St
La Fontaine, IN 46940-9045
Phone
(765) 981-2081
NPI assigned
Feb 19, 2008
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
32001447AINMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 32001447A IN Yes

Addresses

Primary practice location

604 Rennaker St
La Fontaine, IN 46940-9045

Mailing address

1800 N Wabash Ave Suite 200
Marion, IN 46952-1300
Phone (765) 651-3229

Other providers in La Fontaine, IN

All providers in La Fontaine, IN · Occupational Therapy Assistant in Indiana

Sources for this page

Verify at the official NPI Registry.