Individual
AMELIA R WANINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
404 W WILLOW RD, DALE, IN 47523-8947
(812) 937-4489
Mailing address
3323 S STATE ROAD 162, HUNTINGBURG, IN 47542-9506
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31005402A
IN
Other
Enumeration date
12/14/2012
Last updated
12/14/2012
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