Provider Demographics
NPI:1952524761
Name:THER-ACHIEVE
Entity Type:Organization
Organization Name:THER-ACHIEVE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:RANDA
Authorized Official - Middle Name:JO
Authorized Official - Last Name:BRAUNAGEL
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:765-525-7269
Mailing Address - Street 1:5755 E STATE ROAD 244
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46176-8817
Mailing Address - Country:US
Mailing Address - Phone:765-525-7269
Mailing Address - Fax:
Practice Address - Street 1:5755 E STATE ROAD 244
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:IN
Practice Address - Zip Code:46176-8817
Practice Address - Country:US
Practice Address - Phone:765-525-7269
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31000175A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty