Basic Information
Provider Information
NPI: 1538343165
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SABIJON
FirstName: NANCY
MiddleName: Q
NamePrefix:  
NameSuffix:  
Credential: OTR
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4009 N EVERETT RD APT H
Address2:  
City: MUNCIE
State: IN
PostalCode: 473045649
CountryCode: US
TelephoneNumber: 7656645400
FaxNumber: 7656513227
Practice Location
Address1: 1800 N WABASH RD
Address2:  
City: MARION
State: IN
PostalCode: 469521300
CountryCode: US
TelephoneNumber: 7656645400
FaxNumber: 7656513227
Other Information
ProviderEnumerationDate: 12/18/2007
LastUpdateDate: 12/18/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000X31004321AINY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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