Provider Demographics
NPI:1821608563
Name:RAGLE, AMY (OTD, OTR)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:RAGLE
Suffix:
Gender:F
Credentials:OTD, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5217 S 1375 W
Mailing Address - Street 2:
Mailing Address - City:SANDBORN
Mailing Address - State:IN
Mailing Address - Zip Code:47578-5324
Mailing Address - Country:US
Mailing Address - Phone:812-699-2789
Mailing Address - Fax:
Practice Address - Street 1:10 S 9TH ST STE 4
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-2631
Practice Address - Country:US
Practice Address - Phone:317-204-3736
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-07
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31007162A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist