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Individual

MRS. KENDRA ANN RENNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA

Contact information

Practice address
1712 N LELAND DR, HUNTINGBURG, IN 47542-9348
(812) 683-4090
Mailing address
1712 N LELAND DR, HUNTINGBURG, IN 47542-9348
(812) 683-4090

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32001302A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
32001302A
OCCUPATIONAL THERAPY ASSISTANT LICENSE
IN
Enumeration date
04/29/2010
Last updated
04/29/2010
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