Provider Demographics
NPI:1174697304
Name:O'CONNOR, PAULA JEAN (OTR)
Entity type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:JEAN
Last Name:O'CONNOR
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9724 COVINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46037-9168
Mailing Address - Country:US
Mailing Address - Phone:317-577-9082
Mailing Address - Fax:317-786-9272
Practice Address - Street 1:9724 COVINGTON BLVD
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46037-9168
Practice Address - Country:US
Practice Address - Phone:317-577-9082
Practice Address - Fax:317-786-9272
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31000810A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist