Provider Demographics
NPI:1134466329
Name:FIELDS, ALLISON N (COTA)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:N
Last Name:FIELDS
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 MEDICAL DR
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-2923
Mailing Address - Country:US
Mailing Address - Phone:317-573-1037
Mailing Address - Fax:
Practice Address - Street 1:303 N. HURSTBOURNE PARKWAY
Practice Address - Street 2:SUITE 200 PARAGON REHABILITATION
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40222
Practice Address - Country:US
Practice Address - Phone:502-412-5847
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-09
Last Update Date:2014-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN99054673A224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant