Individual
ALYSE DANIELE WOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
10215 BROADWAY, CROWN POINT, IN 46307-8001
(219) 663-8948
Mailing address
6340 E MAIN ST APT 301, PORTAGE, IN 46368-4680
(989) 292-9634
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31006866A
IN
Other
Enumeration date
09/16/2019
Last updated
09/16/2019
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