Individual
MISTY DAWN ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
250 SHENANDOAH DR APT 36, LAFAYETTE, IN 47905-5931
(765) 234-8790
(800) 805-4620
Mailing address
4644 W 375 N, DELPHI, IN 46923-9176
(765) 426-9901
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32001884A
IN
Other
Enumeration date
10/05/2012
Last updated
09/24/2019
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