Individual
EVELINA PEARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1002 WISHARD BLVD STE 2021, INDIANAPOLIS, IN 46202-4164
(317) 944-8868
(317) 944-8860
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31008044A
IN
225X00000X
Occupational Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1104414805
ANTHEM PTAN
IN
05
—
300096735
—
IN
Enumeration date
07/10/2024
Last updated
10/31/2024
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