Individual
BETHANY JANE MAYES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
2626 SAINT JOE CENTER RD, FORT WAYNE, IN 46825-5042
(260) 497-0328
Mailing address
10055 PIN OAK CIR, FORT WAYNE, IN 46835-9321
(843) 810-1183
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32003579A
IN
224Z00000X
Occupational Therapy Assistant
3407
SC
Other
Enumeration date
04/04/2015
Last updated
08/15/2023
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