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1295097848
GWEN RENE TAYLOR
FORT WAYNE, IN
NPI
1295097848
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Former Name
GWEN RENE CLEVENGER
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: IN 32002140A)
Enumeration Date
2012-06-11
Last Update Date
2012-06-11
Business Address
-- GWEN RENE TAYLOR COTA
803 HUFFMAN ST
FORT WAYNE, IN 46808-3245
Phone number: 260-424-3540
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Mailing Address
-- GWEN RENE TAYLOR COTA
803 HUFFMAN ST
FORT WAYNE, IN 46808-3245
Phone number: 260-424-3540
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