Individual
CAROL J EARL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
6040 LUTE RD, PORTAGE, IN 46368-5008
(219) 763-6858
(219) 763-4858
Mailing address
4408 KINGSDALE DR, VALPARAISO, IN 46383-1421
(219) 462-0755
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32000220A
IN
Other
Enumeration date
06/29/2007
Last updated
07/08/2007
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