Individual
MRS. FATEMA LYNN CISCHKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1950 RIDGEDALE RD, SOUTH BEND, IN 46614-2243
(574) 291-6722
(574) 291-8768
Mailing address
55196 HOLMES RD, SOUTH BEND, IN 46628-4912
(574) 310-9198
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32001532A
IN
Other
Enumeration date
04/10/2014
Last updated
04/10/2014
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