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Individual

ANNE L MUMMERT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
917 SAGAMORE PKWY W, WEST LAFAYETTE, IN 47906-1443
(765) 463-2200
(765) 463-3625
Mailing address
PO BOX 4699, LAFAYETTE, IN 47903-4699
(765) 449-2732
(765) 449-1196

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31001067A
IN
225XH1200X
Hand Occupational Therapist
31001067A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000758022
ANTHEM PIN - IU HEALTH ARNETT
IN
05
200036740
IN
Enumeration date
10/02/2006
Last updated
01/07/2013
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