Provider Demographics
NPI:1558555086
Name:LARY, NANCY E (OT)
Entity Type:Individual
Prefix:PROF
First Name:NANCY
Middle Name:E
Last Name:LARY
Suffix:
Gender:F
Credentials:OT
Other - Prefix:MS
Other - First Name:NANCY
Other - Middle Name:CHANDLER
Other - Last Name:ELLIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:516 W LAKE ST
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:IA
Mailing Address - Zip Code:50482-5018
Mailing Address - Country:US
Mailing Address - Phone:641-344-8795
Mailing Address - Fax:
Practice Address - Street 1:490 W LYONS ST
Practice Address - Street 2:
Practice Address - City:GARNER
Practice Address - State:IA
Practice Address - Zip Code:50438-1946
Practice Address - Country:US
Practice Address - Phone:641-923-2677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-28
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1040162225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist