| NPI | 1003459330 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGIE GRAFF Credentialing Manager 317-376-8336 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist |
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2019-10-18 |
| Last Update Date | 2019-10-18 |