Provider Demographics
NPI:1487882585
Name:MEYER, ANN KATHLEEN (OT)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:KATHLEEN
Last Name:MEYER
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 EXECUTIVE DR STE 5
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47905-4881
Mailing Address - Country:US
Mailing Address - Phone:765-446-3800
Mailing Address - Fax:
Practice Address - Street 1:35 EXECUTIVE DR STE 5
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47905-4881
Practice Address - Country:US
Practice Address - Phone:765-446-3800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225X00000X
IN31004683A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist