Individual
LARISSA P SWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS,OTR/L
Contact information
Practice address
377 WESTRIDGE BLVD, GREENWOOD, IN 46142-2137
(317) 888-4948
Mailing address
6356 DEERFIELD DR, GREENWOOD, IN 46143-9151
(317) 859-2196
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31002041A
IN
Other
Enumeration date
07/03/2008
Last updated
07/03/2008
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