Provider Demographics
NPI:1114197811
Name:HASTINGS, MICHELLE (OTR)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:
Last Name:HASTINGS
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 1:12217 CASTLE ROW OVERLOOK
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46033-3123
Mailing Address - Country:US
Mailing Address - Phone:317-575-0571
Mailing Address - Fax:
Practice Address - Street 1:12217 CASTLE ROW OVERLOOK
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46033-3123
Practice Address - Country:US
Practice Address - Phone:317-575-0571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-10
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31004016A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist