Provider Demographics
NPI:1578849220
Name:FRANK, MARY VIRGINIA (OTR)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:VIRGINIA
Last Name:FRANK
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 1:1699 OBARA CT
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46033-9743
Mailing Address - Country:US
Mailing Address - Phone:317-844-8105
Mailing Address - Fax:
Practice Address - Street 1:2045 RAMA DR
Practice Address - Street 2:200
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46219-1710
Practice Address - Country:US
Practice Address - Phone:317-635-3499
Practice Address - Fax:317-635-0499
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-26
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31001658A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist