Individual
MRS. LYNNETTE LATRICE PICKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4419 MARQUETTE DR, FORT WAYNE, IN 46806-4623
(260) 580-4954
Mailing address
4419 MARQUETTE DR, FORT WAYNE, IN 46806-4623
(260) 580-4954
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32001668A
IN
Other
Enumeration date
12/02/2015
Last updated
12/02/2015
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