Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | 31000607A | IN |
N | 225XR0403X | Driving and Community Mobility | 31000607A | IN |
NPI | 1144351107 |
---|---|
Provider Name | Stephanie Wood |
First Address | Fishers, IN 46256 |
Second Address | Indianapolis, IN 46268-5900 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2007 |
Last Update Date | 08/07/2007 |