Provider Demographics
NPI:1932183860
Name:ARVIN, MARYKAY (OTR/CHT)
Entity Type:Individual
Prefix:MRS
First Name:MARYKAY
Middle Name:
Last Name:ARVIN
Suffix:
Gender:F
Credentials:OTR/CHT
Other - Prefix:
Other - First Name:MARYKAY
Other - Middle Name:
Other - Last Name:DEIG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/CHT
Mailing Address - Street 1:7300 E INDIANA ST
Mailing Address - Street 2:STE. 102
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47715-2794
Mailing Address - Country:US
Mailing Address - Phone:812-476-0409
Mailing Address - Fax:812-476-1016
Practice Address - Street 1:7300 E INDIANA ST
Practice Address - Street 2:STE. 102
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-2794
Practice Address - Country:US
Practice Address - Phone:812-476-0409
Practice Address - Fax:812-476-1016
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2010-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31000284A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200839550Medicaid
IN000000199659OtherBLUE CROSS BLUE SHIELD
INP00782326Medicare UPIN
IN255480YMedicare PIN
IN216070LLMedicare PIN