Individual
MARY MCDONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
12110 BUSINESS BLVD, SUITE 6 PMB 413, EAGLE RIVER, AK 99577-7725
(907) 317-9349
(866) 628-8601
Mailing address
4255 POLK RD, BOONVILLE, IN 47601-8056
(812) 480-1363
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
PHY T 2675
AK
Other
Enumeration date
12/09/2013
Last updated
12/09/2013
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