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Individual

MRS. MONICA ASHLEY TELLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
8143 HOHMAN AVE, MUNSTER, IN 46321-1507
(219) 743-7944
Mailing address
8143 HOHMAN AVE, MUNSTER, IN 46321-1507

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
057.004010
IL
224Z00000X
Occupational Therapy Assistant
Primary
32002653A
IN

Other

Enumeration date
06/03/2020
Last updated
06/03/2020
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