Provider Demographics
NPI:1780474361
Name:LONG, CHLOE CATHERINE (OTR/L)
Entity type:Individual
Prefix:
First Name:CHLOE
Middle Name:CATHERINE
Last Name:LONG
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17933 EXCURSION DR APT 107
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46062-0111
Mailing Address - Country:US
Mailing Address - Phone:530-842-0140
Mailing Address - Fax:
Practice Address - Street 1:9885 E 116TH ST STE 400
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46037-9243
Practice Address - Country:US
Practice Address - Phone:317-682-1872
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-08
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2025012121225X00000X
IN31008700A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist