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Individual

TINA MARIE WHITE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA

Contact information

Practice address
1345 NORTH MADISON AVE, ANDERSON, IN 46011-1215
(765) 644-2888
Mailing address
12712 JUSTICE CROSSING, FISHERS, IN 46037
(317) 776-1679

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32001003A
IN

Other

Enumeration date
10/09/2009
Last updated
10/09/2009
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