Individual
MRS. ELIZABETH M WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
303 N WASHINGTON ST, WAKARUSA, IN 46573-9590
(574) 862-4511
Mailing address
22327 SOMMERSET PLACE BLVD, GOSHEN, IN 46528-8317
(574) 215-2035
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32002000A
IN
Other
Enumeration date
10/31/2022
Last updated
10/31/2022
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