Individual
MRS. JODI LYN VAN VELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T.R.
Contact information
Practice address
2121 LAKE AVE, FORT WAYNE, IN 46805-5100
(260) 426-5431
Mailing address
6527 CHASE CREEK RUN, FORT WAYNE, IN 46804-8706
(260) 602-6595
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31001661A
IN
Other
Enumeration date
10/12/2020
Last updated
10/12/2020
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