Provider Demographics
NPI:1134529142
Name:MCKAY, MICHELLE (OTR)
Entity type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:
Last Name:MCKAY
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 1:15285 SMITHFIELD DR
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46074-8069
Mailing Address - Country:US
Mailing Address - Phone:317-529-9575
Mailing Address - Fax:
Practice Address - Street 1:1335 S GUILFORD RD
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-2999
Practice Address - Country:US
Practice Address - Phone:877-556-0364
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-27
Last Update Date:2014-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31003042A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist