Individual
TARA LEE MONCHILOVICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
326 COUNTRY CLUB DR, NEW ALBANY, IN 47150-4618
(812) 948-1311
Mailing address
118 MEDICAL DR, CARMEL, IN 46032-3323
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32003366A
IN
Other
Enumeration date
03/10/2023
Last updated
03/10/2023
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