Individual
CANDACE BINGAMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
630 CHEYENNE DR, LOWELL, IN 46356-1624
(219) 775-5607
Mailing address
630 CHEYENNE DR, LOWELL, IN 46356-1624
(219) 775-5607
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32003079A
IN
Other
Enumeration date
08/26/2016
Last updated
08/26/2016
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