| NPI | 1992963813 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA SUZANNE MANGAN Co Owner 219-983-9675 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: IN 31003944a) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IN 05008714A) |
| 235Z00000X Speech-Language Pathologist, (Licence: IN 46001702A) | |
| Enumeration Date | 2008-05-28 |
| Last Update Date | 2008-05-28 |