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Individual

LISA TUYET TRAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
6239 S EAST ST STE A, INDIANAPOLIS, IN 46227-2088
(812) 390-6736
Mailing address
6239 S EAST ST STE A, INDIANAPOLIS, IN 46227-2088
(812) 390-6736

Taxonomy

Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
222Q00000X
IN
Enumeration date
10/05/2018
Last updated
10/05/2018
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