Individual
MARGARET TRACY MENDOZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
118 MEDICAL DR, CARMEL, IN 46032-3323
(818) 257-2833
Mailing address
9060 BRADWELL PL APT 208, FISHERS, IN 46037-8626
(818) 257-2833
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32003294A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
32003294A
INDIANA PROFESSIONAL LICENSING AGENCY
IN
Enumeration date
07/31/2018
Last updated
07/31/2018
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