Provider Demographics
NPI:1093998932
Name:MCCARTY, PATTY S (OTR)
Entity Type:Individual
Prefix:
First Name:PATTY
Middle Name:S
Last Name:MCCARTY
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 HIGHLAND PARK DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURY
Mailing Address - State:IN
Mailing Address - Zip Code:46540-9000
Mailing Address - Country:US
Mailing Address - Phone:574-358-0077
Mailing Address - Fax:574-358-0079
Practice Address - Street 1:101 HIGHLAND PARK DR
Practice Address - Street 2:
Practice Address - City:MIDDLEBURY
Practice Address - State:IN
Practice Address - Zip Code:46540-9000
Practice Address - Country:US
Practice Address - Phone:574-358-0077
Practice Address - Fax:574-358-0079
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-13
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31001240A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist