Individual
MIRIAM JEWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10000 COLUMBIA AVE, MUNSTER, IN 46321-4041
(219) 934-0750
Mailing address
3447 167TH ST, HAMMOND, IN 46323-1801
(708) 539-7696
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32003853A
IN
Other
Enumeration date
04/18/2024
Last updated
04/18/2024
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