Individual
JESSIE HAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5610 E MICHIGAN ST, INDIANAPOLIS, IN 46219-5815
(260) 229-7170
Mailing address
1360 LIGHTHOUSE PT, CICERO, IN 46034-9419
(260) 229-7170
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32001327A
IN
Other
Enumeration date
03/09/2015
Last updated
04/12/2021
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