Provider Demographics
NPI:1154515401
Name:HYMAN, PHYLLIS MARIE (MOT, OTR/L)
Entity type:Individual
Prefix:MRS
First Name:PHYLLIS
Middle Name:MARIE
Last Name:HYMAN
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10559 MARLIN CT
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46256-9745
Mailing Address - Country:US
Mailing Address - Phone:317-598-9335
Mailing Address - Fax:
Practice Address - Street 1:10559 MARLIN CT
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46256-9745
Practice Address - Country:US
Practice Address - Phone:317-598-9335
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-29
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31003799A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist