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Individual

MRS. WANDA BETH HOPPER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OT

Contact information

Practice address
6844 PARK SQUARE DR APT A, AVON, IN 46123-8897
(317) 272-0899
Mailing address
6844 PARK SQUARE DR APT A, AVON, IN 46123-8897
(317) 272-0899

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31000568A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
31000568A
OCCUPATIONAL THERAPIST
IN
Enumeration date
05/17/2007
Last updated
07/08/2007
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