Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 32000511A | IN |
NPI | 1023641123 |
---|---|
Provider Name | Ms. Lisa A Arteaga |
First Address | Munster, IN 46321-1506 |
Second Address | St John, IN 46373 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/02/2020 |
Last Update Date | 17/02/2020 |