| NPI | 1336809193 |
|---|---|
| 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 |