Provider Demographics
NPI:1255618393
Name:ROHRBACH-KIM, SHAWN MARIE (OT, CHT)
Entity type:Individual
Prefix:MRS
First Name:SHAWN
Middle Name:MARIE
Last Name:ROHRBACH-KIM
Suffix:
Gender:F
Credentials:OT, CHT
Other - Prefix:MRS
Other - First Name:SHAWN
Other - Middle Name:MARIE
Other - Last Name:KIM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OT, CHT
Mailing Address - Street 1:13121 OLIO RD
Mailing Address - Street 2:STE. 140
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46037-7237
Mailing Address - Country:US
Mailing Address - Phone:317-621-1400
Mailing Address - Fax:317-621-1410
Practice Address - Street 1:13121 OLIO RD
Practice Address - Street 2:STE. 140
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46037-7237
Practice Address - Country:US
Practice Address - Phone:317-621-1400
Practice Address - Fax:317-621-1410
Is Sole Proprietor?:No
Enumeration Date:2011-11-03
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31003824A225X00000X, 225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist