Individual
STEFANIE PEREGRIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OCCUPATIONAL THERAPI
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31003259A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000243268
ANTHEM BLUE CROSS
—
01
—
000000622162
ANTHEM PROVIDER NUMBER / ARNETT CLINIC, LLC
IN
05
—
200957340
—
IN
Enumeration date
04/24/2007
Last updated
10/01/2010
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