Provider Demographics
NPI:1881822294
Name:POUND, PATRICIA SUE (OT)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:SUE
Last Name:POUND
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:SUE
Other - Last Name:ROBB
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OT
Mailing Address - Street 1:10576 S US HIGHWAY 41
Mailing Address - Street 2:
Mailing Address - City:ROSEDALE
Mailing Address - State:IN
Mailing Address - Zip Code:47874-7052
Mailing Address - Country:US
Mailing Address - Phone:765-592-0746
Mailing Address - Fax:
Practice Address - Street 1:1206 E NATIONAL AVE
Practice Address - Street 2:
Practice Address - City:BRAZIL
Practice Address - State:IN
Practice Address - Zip Code:47834-2718
Practice Address - Country:US
Practice Address - Phone:812-442-2635
Practice Address - Fax:812-442-2630
Is Sole Proprietor?:No
Enumeration Date:2009-06-24
Last Update Date:2009-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31004416A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist