Individual
DARCIE A GRESHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
6040 LUTE RD, PORTAGE, IN 46368-5008
(219) 763-6858
(219) 763-4858
Mailing address
262 HILLCREST AVE, HOBART, IN 46342-3587
(219) 945-4955
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31001235A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31001235A
OTR
IN
Enumeration date
07/10/2007
Last updated
07/10/2007
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