Provider Demographics
NPI:1043538119
Name:FRISBY, CAROL YVONNE (OT)
Entity Type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:YVONNE
Last Name:FRISBY
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 17901
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46217-0901
Mailing Address - Country:US
Mailing Address - Phone:463-212-4227
Mailing Address - Fax:
Practice Address - Street 1:5633 NEWHALL PL
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46239-8949
Practice Address - Country:US
Practice Address - Phone:317-366-4265
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-13
Last Update Date:2019-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31004409A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist