Individual
MRS. MELISSA A ETZLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11650 LANTERN RD STE 235, FISHERS, IN 46038-3106
(317) 576-8410
(888) 654-4116
Mailing address
11650 N. LANTERN ROAD, SUITE 235, FISHERS, IN 46038
(317) 576-8410
(888) 654-4116
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31002303A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31002303A
OCCUPATIONAL THERAPY LICENSE
IN
Enumeration date
06/05/2012
Last updated
06/05/2012
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