Individual
LILLIANNE CAROLIINE LOUISE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7701 E 21ST ST, INDIANAPOLIS, IN 46219-2406
(317) 513-1986
Mailing address
7701 E 21ST ST, INDIANAPOLIS, IN 46219-2406
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
29002073A
IN
Other
Enumeration date
03/22/2024
Last updated
03/22/2024
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