NPI | 1073273835 |
---|---|
Entity Type | Organization |
Authorized Contact | ANGIE GRAFF Contracting & 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 | 2021-12-21 |
Last Update Date | 2021-12-21 |