Provider Demographics
NPI:1760780332
Name:PATHS LLC
Entity Type:Organization
Organization Name:PATHS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:HECKER
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:812-760-7283
Mailing Address - Street 1:2493 S CRABTREE DR
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:IN
Mailing Address - Zip Code:47670-9360
Mailing Address - Country:US
Mailing Address - Phone:812-760-7283
Mailing Address - Fax:
Practice Address - Street 1:2493 S CRABTREE DR
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:IN
Practice Address - Zip Code:47670-9360
Practice Address - Country:US
Practice Address - Phone:812-760-7283
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-07
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31003563A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty