Individual
VANESSA RENEE RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, OTR
Contact information
Practice address
21 S PARK BLVD STE 21, GREENWOOD, IN 46143-8838
(317) 449-2104
(317) 520-8200
Mailing address
124 HAWTHORNE LN, GREENWOOD, IN 46142-9430
(317) 332-9861
(317) 893-4453
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31007103A
IN
225XP0200X
Pediatric Occupational Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
433646
NBCOT
—
Enumeration date
04/08/2020
Last updated
11/24/2020
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