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Individual

MS. MICHELLE ANN EWING

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
COTA

Contact information

Practice address
4895 PINE RIDGE DR, COLUMBUS, IN 47201-2569
(812) 342-3098
(812) 342-3288
Mailing address
4895 PINE RIDGE DR, COLUMBUS, IN 47201-2569
(812) 342-3098
(812) 342-3288

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32001810A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
32001810A
COTA LICENSE
IN
Enumeration date
03/18/2010
Last updated
03/18/2010
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