Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 31006848A | IN |
NPI | 1003467903 |
---|---|
Provider Name | Danielle Nicole Wills |
First Address | Pendleton, IN 46064-8578 |
Second Address | Muncie, IN 47304-5407 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2019 |
Last Update Date | 07/12/2021 |