Individual
DENISE MARIE DRAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS OT
Contact information
Practice address
5949 W RAYMOND ST, INDIANAPOLIS, IN 46241-4348
(317) 390-5575
(317) 486-2189
Mailing address
790 REMINGTON BLVD., BOLINGBROOK, IL 60440-4909
(630) 296-2223
(317) 486-2189
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31004693A
IN
225XH1200X
Hand Occupational Therapist
5527
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200922680
—
IN
01
—
P01023494
MEDIDCARE RR
IN
Enumeration date
08/24/2007
Last updated
05/24/2012
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