Individual
EMILY ANN BACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTD, OTR/L
Contact information
Practice address
4740 KINGSWAY DR, INDIANAPOLIS, IN 46205-1521
(317) 466-1000
Mailing address
4740 KINGSWAY DR, INDIANAPOLIS, IN 46205-1521
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31007935A
IN
Other
Enumeration date
05/23/2023
Last updated
05/23/2023
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