| NPI | 1770116949 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGIE GRAFF Credentialing Manager 317-376-8336 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2020-02-17 |
| Last Update Date | 2021-07-13 |