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Individual
BONNIE GAIL BEAL
Active
Individual
BONNIE GAIL BEAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR CHT
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31000461A
IN
225XH1200X
Hand Occupational Therapist
31000461A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000179357
ANTHEM HEALTH PLAN
—
01
—
062110009
MEDICARE PTAN
IN
05
—
200037020
—
IN
01
—
67000268
RR MEDICARE
IN
Enumeration date
10/04/2006
Last updated
08/30/2017
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