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Organization
123OT, LLP
Active
Organization
123OT, LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACI LEDET (COTA)
(260) 243-1198
Entity
Organization
Contact information
Practice address
10335 CORYDON CT, INDIANAPOLIS, IN 46239-9781
(317) 437-0848
Mailing address
10335 CORYDON CT, INDIANAPOLIS, IN 46239-9781
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
—
NULL
224Z00000X
Occupational Therapy Assistant
—
—
225X00000X
Occupational Therapist
Primary
—
NULL
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
02/09/2020
Last updated
02/09/2020
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