| NPI | 1184899593 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLLEEN M WASEMANN Co Owner 317-753-0930 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: IN 31003434A) |
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics |
| Enumeration Date | 2008-04-25 |
| Last Update Date | 2020-04-21 |