Individual
KRISTAIN JOAN PUCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
7209 N SHADELAND AVE, INDIANAPOLIS, IN 46250-2021
(317) 288-7606
Mailing address
7209 N SHADELAND AVE, INDIANAPOLIS, IN 46250-2021
(317) 288-7606
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201009170
MI
Other
Enumeration date
07/13/2015
Last updated
10/02/2024
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