Individual
MRS. SANDRA LEE ROACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1251 W 96TH ST # N, INDIANAPOLIS, IN 46260-1181
(317) 407-5361
Mailing address
314 W 107TH ST, CARMEL, IN 46032-9587
(317) 571-9296
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32000132A
IN
Other
Enumeration date
10/05/2007
Last updated
10/05/2007
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