Individual
REBECCA TUBERGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
201 PENNSYLVANIA PKWY, STE 100, INDIANAPOLIS, IN 46280-1393
(317) 817-1200
(317) 817-1220
Mailing address
201 PENNSYLVANIA PKWY, STE 100, INDIANAPOLIS, IN 46280-1393
(317) 817-1200
(317) 817-1220
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31002140
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200396460
—
IN
Enumeration date
07/09/2006
Last updated
06/06/2016
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