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Individual

REBECCA TERBROCK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4764 CHARRINGTON CIR, INDIANAPOLIS, IN 46254-9671
(317) 405-9016
(888) 654-4116
Mailing address
4764 CHARRINGTON CIR, INDIANAPOLIS, IN 46254-9671
(317) 405-9016
(888) 654-4116

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31005542A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
31005542A
INDIANA OCCUPATIONAL LICENSE
IN
Enumeration date
09/03/2014
Last updated
09/03/2014
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