Individual
BONNIE GAIL BEAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR CHT
Contact information
Practice address
8501 HARCOURT RD, INDIANAPOLIS, IN 46260
(317) 875-9105
(317) 875-8638
Mailing address
8501 HARCOURT RD, INDIANAPOLIS, IN 46260
(317) 875-9105
(317) 875-8638
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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