Provider Demographics
NPI:1326367442
Name:GOLDFARB, JOAN ANN (MS OTR)
Entity Type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:ANN
Last Name:GOLDFARB
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 1:11776 E 216TH ST
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46060-7540
Mailing Address - Country:US
Mailing Address - Phone:317-770-7024
Mailing Address - Fax:
Practice Address - Street 1:7242 WHITEHALL DR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46256-2273
Practice Address - Country:US
Practice Address - Phone:317-288-7606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-28
Last Update Date:2010-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31004957A225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics