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1609012582
HAZEL NALYN BASA
FORT WAYNE, IN
NPI
1609012582
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: IN 32001575A)
Enumeration Date
2008-12-26
Last Update Date
2008-12-26
Business Address
HAZEL NALYN BASA COTA
2237 ENGLE RD
FORT WAYNE, IN 46809-1404
Phone number: 260-747-2353
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Mailing Address
HAZEL NALYN BASA COTA
1800 N WABASH RD STE 200
MARION, IN 46952-1300
Phone number: 765-651-3229
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