Provider Demographics
NPI:1043456627
Name:EKLOF, VICKI LYNN (MS, OTR)
Entity Type:Individual
Prefix:MISS
First Name:VICKI
Middle Name:LYNN
Last Name:EKLOF
Suffix:
Gender:F
Credentials:MS, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 S COUNTY ROAD 525 E
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:IN
Mailing Address - Zip Code:46123-8361
Mailing Address - Country:US
Mailing Address - Phone:317-745-1390
Mailing Address - Fax:317-745-2991
Practice Address - Street 1:445 S COUNTY ROAD 525 E
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:IN
Practice Address - Zip Code:46123-8361
Practice Address - Country:US
Practice Address - Phone:317-745-1390
Practice Address - Fax:317-745-2991
Is Sole Proprietor?:No
Enumeration Date:2009-01-01
Last Update Date:2009-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31000434A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist