Individual
LINDA BUCKLEY
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
5949 W RAYMOND ST, INDIANAPOLIS, IN 46241-4348
(317) 390-5575
(317) 486-2189
Mailing address
5949 W RAYMOND ST, INDIANAPOLIS, IN 46241-4348
(317) 390-5575
(317) 486-2189
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31000254A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000329508
ANTHEM ID
IN
Enumeration date
04/06/2006
Last updated
07/09/2007
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