Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 31007518A | IN |
NPI | 1063182392 |
---|---|
Provider Name | Dena Awad |
First Address | Fishers, IN 46038-2006 |
Second Address | Fishers, IN 46038-2006 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/09/2021 |
Last Update Date | 17/09/2021 |